WO2002089692A1 - Method and device for guiding the movement of at least one reference point in relation to a body - Google Patents

Method and device for guiding the movement of at least one reference point in relation to a body Download PDF

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Publication number
WO2002089692A1
WO2002089692A1 PCT/FR2001/001355 FR0101355W WO02089692A1 WO 2002089692 A1 WO2002089692 A1 WO 2002089692A1 FR 0101355 W FR0101355 W FR 0101355W WO 02089692 A1 WO02089692 A1 WO 02089692A1
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WO
WIPO (PCT)
Prior art keywords
image
producing
point
frame
guiding
Prior art date
Application number
PCT/FR2001/001355
Other languages
French (fr)
Inventor
Raymond René DERYCKE
Original Assignee
Areall
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.)
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Publication date
Application filed by Areall filed Critical Areall
Priority to PCT/FR2001/001355 priority Critical patent/WO2002089692A1/en
Publication of WO2002089692A1 publication Critical patent/WO2002089692A1/en

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Classifications

    • 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
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072—Reference field transducer attached to an instrument or patient
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4504—Bones
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods
    • A61C9/0086—Acoustic means or methods

Definitions

  • the present invention relates to methods for guiding the movement of at least one reference point relative to a body, which find an advantageous application in the medical field and more particularly in the dental field to, for example, help dentists to perform dental implants.
  • the present invention also relates to the devices for implementing these methods, for guiding the movement of at least one reference point relative to a body.
  • Modern dental techniques make it possible to replace damaged teeth with artificial teeth which are implanted, for example by means of pivots. To be able to implant these teeth, it is necessary to make, in the bony part of the maxilla, a pilot hole in which the pivot of the replacement tooth is placed.
  • This solution may be acceptable when the body is relatively accessible and has good homogeneity.
  • this body consists, for example, of a jaw with its teeth, comprising enamel, dentin, flesh, amalgams or the like.
  • the 3D image is not perfectly representative of the body and it is therefore impossible to precisely guide the point of reference with respect to the body, which can be a very serious drawback when this method is for example used in the field of dental surgery or the like.
  • the object of the present invention is to implement a method for guiding the movement of at least one reference point relative to a body, which allows, in particular in the dental field but not exclusively, to alleviate the drawbacks of the methods of the prior art and therefore more easily perform work of very good quality, while reducing the intervention time on patients.
  • the subject of the present invention is a method for guiding the movement of at least one reference point with respect to a body, consisting in: producing a 3D image from said body in a given frame of reference, producing an image of said body reference point in said reference frame, and in guiding said reference point with respect to said body in said reference frame by means of said 3D image produced from said body and of the image of said reference point, characterized in that said 3D image produced from said body in the given frame of reference is obtained: by producing, on the one hand, a first 3D image of the body by means of a first radiation beam, and on the other hand a second 3D image of said body, this second image 3D being defined by a plurality of finite number image points corresponding to sample points on the surface of said body, these sample points being defined by relative to the given frame of reference, then by indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in the given frame of reference, this so-called third 3D image being the 3D image produced from
  • the present invention also relates to a device making it possible to implement the method defined above to guide the movement of at least one reference point relative to a body, characterized in that it comprises: means for producing a first 3D image of the body by means of a first radiation beam, means for producing a second 3D image of said body, this second 3D image being defined by a plurality of image points in finite numbers corresponding to sample points on the surface of said body, these sample points being defined with respect to a given reference frame, means for indexing the first 3D image with respect to the second 3D image to obtain a third 3D image referenced in said reference frame, means for producing an image of said point in said reference frame, and means for guiding said point relative to said body in said reference frame by means of said third 3D image and of the image of said point.
  • FIG. 1 is the block diagram of implementation of the method according to the invention for guiding the displacement of at least one reference point relative to a body
  • FIG. 2 represents the block diagram of a device making it possible to implement the method according to the invention, in an application in the dental field.
  • the present invention relates to a method for guiding the movement of at least one reference point P r with respect to a body K which finds advantageous applications in the medical field, and more particularly dental.
  • An example of implementation of the method is described below in a dental application for very precisely implanting artificial teeth by means of pivots or the like, it being understood that this method can also be applied without any difficulty in other fields of application and whatever the nature of the body K.
  • the block diagram of the method according to the invention is shown in FIG. 1.
  • the method consists first of all in producing a first 3D image of the body K, a three-dimensional image (image I, FIG. 1), by means of a first beam of radiation.
  • the first 3D image is that of the part of the jaw 1 comprising the location 2 of the tooth to be replaced and the set of teeth 3 which are in the vicinity of this location 2, as well as that of the portion of the jaw bone 4 which carries these teeth 3 and this first 3D image is obtained by means of at least one of the The following radiation beams: X-ray beam, light radiation beam, ultrasound beam or the like.
  • the first radiation beam used is an X-ray beam (RAY.X) which advantageously makes it possible to penetrate into the enamel and the dentine of the teeth, as well as into the bone in which the teeth are implanted.
  • Such a 3D image is obtained in a manner well known in itself. It can be obtained by means for example of a source 5 of X-rays, FIG. 2, of a scintillator 6 which receives the X-rays which have passed through the body and which transforms them into light signals, and of a converter 7, like a CCD sensor or the like, which converts these light signals into analog or digital electrical signals. These electrical signals are then processed by means of a processing member 8 controlled by a programmer 28 of the computer or similar type, known in itself, to form a video image 9 displayed on a video screen 10 or the like.
  • the process then consists in producing (ARM ARITEfigure 1) a second 3D image of the body (image II, figure 1), this second 3D image being defined by a plurality of image points in finite number corresponding to sample points of the surface of the body K, these sample points being defined with respect to a given frame of reference.
  • This second 3D image can be obtained in a manner known per se, for example by means of a poly-articulated robot measurement arm, schematically illustrated at 12 in FIG. 2.
  • the signals delivered by the poly-articulated arm each once it is pointed at a sample point on the surface of the body K are applied to an input of the processing member 8 which transforms them into signals which are processed to give image points, for example video points, which, from the made of the structure of the robot arm 12, are perfectly determined and referenced by an address in a reference frame R (for example in X, Y and Z), FIG. 2, for example linked to the robot itself.
  • the method consists (INDEX. FIG. 1) then in indexing the first 3D image with respect to the second 3D image for example in the processing member 8, FIG. 2, in a manner known in it -even by means of software for controlling the movement of images which are currently commercially available and which make it possible to move a video image, in this case the first 3D image, on a video screen, in order to superimpose it on another video image, in this case the second 3D image, so that the maximum of image points of the sample points merge with the corresponding image points of the first 3D image.
  • three sample points are sufficient to obtain this superposition, but it is obvious that the result will be easier to obtain and more reliable if the number of sample points is greater.
  • a third 3D image is obtained (image III, FIG. 1) identical to the first but referenced in the repository R defined above, each of its points being defined by its address in this repository.
  • the method then consists in making an image of the point Pr in the same frame of reference R, (ARM MAN., FIG. 1), for example with an articulated robot arm 13 of the same type as that described above, which is visualized in the image 9 on the video screen 10, FIG. 2.
  • R the same frame of reference
  • the body K is the jaw 1 of a patient and the point P r is for example a point linked to the drill bit 16 for piercing the jaw bone 4 to prepare the implantation of a replacement tooth at location 2.
  • the drill bit 16 being linked to the treatment member 8 by the articulated arm 13, it is easy for the practitioner to position it exactly at the desired location 2 of the body K, by a simple observation of the image 9 on the video screen without having to observe in situ the movement of this wick itself.
  • the method according to the invention also consists in indexing the body K relative to the reference frame R .
  • the device making it possible to implement the method according to the invention may further comprise means for indexing the body K relative to the reference frame R.
  • These means can be of any type, for example an arm 22 of the same type as those which are referenced 12 or 13. This indexing makes it possible to position the third 3D image as a function of the movements of the body K and to obtain at all times, on the screen 10, a perfect correlation between this third 3D image and the real position of the patient.
  • the method described above gives good results in itself.
  • the image obtained may have dark parts or parasitic images due in particular to the scattering of X-rays which limit its quality. This is the case with the first 3D image.
  • the first 3D image obtained therefore often includes parasitic images known to technicians under the term of artifacts.
  • the method consists, in addition to the phases described above, in producing a fourth 3D image of the body K by means of a second radiation beam at least partially reflecting on the surface of the body.
  • the method then consists in processing the first 3D image with the fourth 3D image to obtain a first 3D image corrected for its artifacts (COR, FIG. 1).
  • the first 3D image corrected of its artefacts displayed on the video screen 10 represents perfectly and in volume, the body K which must be analyzed, that is to say in the case of the application cited as for example, all the part of the dentition concerned for the implantation of a replacement tooth, this representation of the body K comprising a minimum number of defects which could disturb the observation of the practitioner.
  • the fourth 3D image can be obtained in situ, by means of two beams, a beam of light radiation for the crown of the teeth and a beam of ultrasound for the collar. teeth and jaw bone.
  • a beam of light radiation for the crown of the teeth
  • a beam of ultrasound for the collar. teeth and jaw bone.
  • this fourth 3D image is obtained from an imprint or the like, it too may have defects. Consequently, advantageously, it is possible to verify this fourth 3D image by means of the second, and possibly to subject it to corrections as a function of the definition of this second image which, for its part, is certain, since it is obtained directly from from the body itself.
  • the practitioner who wants to implant a tooth can visualize, on the third 3D image, the axis 15 along which the replacement tooth should be implanted, axis which he has defined perfectly in relation to the other teeth 3 and to the bone. of the jaw 4. He can then position the drill bit 16 of the drill 14 and control its movement so that the axis of the drill bit is perfectly coincident with the implantation axis 15 and remains constant as and when it enters the bone for the realization of the pilot hole 17. This operation is always possible, even if the patient moves because, by its indexing in the same frame of reference R via the means 22, the third image moves in correlation with the movements of the patient, this which allows the practitioner to be able to constantly position the wick 16 correctly relative to the patient.

Abstract

The invention relates to methods that are used to guide the movement of at least one reference point Pr in relation to a body K. Said method is characterised essentially in that it consists in: producing a first 3D image of body K using a radiation beam, a second 3D image of body K defined by numerous, but finite, image points corresponding to the sample points of the surface of body K which are defined in relation to a given reference system R; indexing the first 3D image in relation to the second 3D image in order to obtain a third 3D image which is referenced in reference system R, (means 8); producing an image of point Pr in reference system R; and guiding point Pr in relation to body K in reference system R using the third 3D image and the image of point Pr. The invention also relates to the device using said method and is particularly, although not exclusively, suitable for the medical field, for example, in dentistry to help dentists implant replacement teeth.

Description

PROCEDE ET DISPOSITIF POUR GUIDER LE DEPLACEMENT D'AU MOINS UN POINT DE REFERENCE PAR RAPPORT A UN CORPS METHOD AND DEVICE FOR GUIDING THE MOVEMENT OF AT LEAST ONE REFERENCE POINT WITH RESPECT TO A BODY
La présente invention concerne les procédés pour guider le déplacement d'au moins un point de référence par rapport à un corps, qui trouvent une application avantageuse dans le domaine médical et plus particulièrement dans le domaine dentaire pour, par exemple, aider les dentistes à réaliser des implants dentaires.The present invention relates to methods for guiding the movement of at least one reference point relative to a body, which find an advantageous application in the medical field and more particularly in the dental field to, for example, help dentists to perform dental implants.
La présente invention concerne aussi les dispositifs pour mettre en œuvre ces procédés, pour guider le déplacement d'au moins un point de référence par rapport à un corps.The present invention also relates to the devices for implementing these methods, for guiding the movement of at least one reference point relative to a body.
Les techniques dentaires modernes permettent de remplacer des dents abîmées par des dents artificielles qui sont implantées, par exemple au moyen de pivots. Pour pouvoir implanter ces dents, il est nécessaire de réaliser, dans la partie osseuse du maxillaire, un avant-trou dans lequel est disposé le pivot de la dent de remplacement.Modern dental techniques make it possible to replace damaged teeth with artificial teeth which are implanted, for example by means of pivots. To be able to implant these teeth, it is necessary to make, in the bony part of the maxilla, a pilot hole in which the pivot of the replacement tooth is placed.
Il est bien évident que, pour que la dent de remplacement soit parfaitement positionnée, notamment par rapport aux dents environnantes restantes et par rapport au maxillaire, il est nécessaire que l'axe de l'avant-trou soit parfaitement défini. Or, l'endroit où doit être réalisé l'avant-trou est souvent difficilement accessible et ne présente généralement pas une visibilité excellente, ce qui ne permet pas au praticien de réaliser à coup sûr et de façon précise un avant-trou idéalement situé.It is obvious that, in order for the replacement tooth to be perfectly positioned, in particular with respect to the remaining surrounding teeth and with respect to the maxilla, it is necessary that the axis of the pilot hole is perfectly defined. However, the place where the pilot hole must be made is often difficult to access and generally does not have excellent visibility, which does not allow the practitioner to make a sure and precise pre-hole ideally located.
Il est déjà connu, notamment par le US-A-5 230 623, un procédé pour guider le déplacement d'au moins un point de référence par rapport à un corps, qui consiste essentiellement à réaliser une image 3D à partir de points extérieurs du corps dans un référentiel donné, à réaliser une image du point de référence dans ce référentiel, et à guider ce point de référence par rapport au corps dans le référentiel, au moyen de l'image 3D réalisée à partir du corps et de l'image du point de référence.It is already known, in particular from US-A-5,230,623, a method for guiding the movement of at least one reference point relative to a body, which essentially consists in producing a 3D image from external points of the body in a given frame of reference, to make an image of the reference point in this frame of reference, and to guide this reference point in relation to the body in the frame of reference, by means of the 3D image produced from the body and the image from the reference point.
Cette solution peut être acceptable lorsque le corps est relativement accessible et présente une bonne homogénéité.This solution may be acceptable when the body is relatively accessible and has good homogeneity.
Or, tel n'est pas le cas lorsque ce corps est par exemple constitué d'une mâchoire avec sa dentition, comportant de l'émail, de la dentine, de la chair, des amalgames ou analogues. Dans ces conditions, l'image 3D n'est pas parfaitement représentative du corps et il est alors impossible de guider avec précision le point de référence par rapport au corps, ce qui peut être un inconvénient très grave lorsque ce procédé est par exemple utilisé dans le domaine de la chirurgie dentaire ou analogue.However, this is not the case when this body consists, for example, of a jaw with its teeth, comprising enamel, dentin, flesh, amalgams or the like. Under these conditions, the 3D image is not perfectly representative of the body and it is therefore impossible to precisely guide the point of reference with respect to the body, which can be a very serious drawback when this method is for example used in the field of dental surgery or the like.
Aussi, la présente invention a-t-elle pour but de mettre en oeuvre un procédé pour guider le déplacement d'au moins un point de référence par rapport à un corps, qui permette, notamment dans le domaine dentaire mais pas exclusivement, de pallier les inconvénients des procédés de l'art antérieur et donc d'effectuer plus facilement un travail de très belle qualité, tout en réduisant le temps d'intervention sur les patients. Plus précisément, la présente invention a pour objet un procédé pour guider le déplacement d'au moins un point de référence par rapport à un corps, consistant: à réaliser une image 3D à partir dudit corps dans un référentiel donné, à réaliser une image dudit point de référence dans ledit référentiel, et à guider ledit point de référence par rapport audit corps dans ledit référentiel au moyen de ladite image 3D réalisée à partir dudit corps et de l'image dudit point de référence, caractérisé par le fait que ladite image 3D réalisée à partir dudit corps dans le référentiel donné est obtenue : en réalisant, d'une part une première image 3D du corps au moyen d'un premier faisceau de rayonnement, et d'autre part une deuxième image 3D dudit corps, cette deuxième image 3D étant définie par une pluralité de points images en nombre fini correspondant à des points échantillons de la surface dudit corps, ces points échantillons étant définis par rapport au référentiel donné, puis en indexant la première image 3D par rapport à la deuxième image 3D pour obtenir une troisième image 3D référencée dans le référentiel donné, cette dite troisième image 3D étant l'image 3D réalisée à partir dudit corps.Therefore, the object of the present invention is to implement a method for guiding the movement of at least one reference point relative to a body, which allows, in particular in the dental field but not exclusively, to alleviate the drawbacks of the methods of the prior art and therefore more easily perform work of very good quality, while reducing the intervention time on patients. More specifically, the subject of the present invention is a method for guiding the movement of at least one reference point with respect to a body, consisting in: producing a 3D image from said body in a given frame of reference, producing an image of said body reference point in said reference frame, and in guiding said reference point with respect to said body in said reference frame by means of said 3D image produced from said body and of the image of said reference point, characterized in that said 3D image produced from said body in the given frame of reference is obtained: by producing, on the one hand, a first 3D image of the body by means of a first radiation beam, and on the other hand a second 3D image of said body, this second image 3D being defined by a plurality of finite number image points corresponding to sample points on the surface of said body, these sample points being defined by relative to the given frame of reference, then by indexing the first 3D image relative to the second 3D image to obtain a third 3D image referenced in the given frame of reference, this so-called third 3D image being the 3D image produced from said body.
La présente invention a aussi pour objet un dispositif permettant de mettre en œuvre le procédé défini ci-dessus pour guider le déplacement d'au moins un point de référence par rapport à un corps, caractérisé par le fait qu'il comporte: des moyens pour réaliser une première image 3D du corps au moyen d'un premier faisceau de rayonnement, des moyens pour réaliser une deuxième image 3D dudit corps, cette deuxième image 3D étant définie par une pluralité de points images en nombre fini correspondant à des points échantillons de la surface dudit corps, ces points échantillons étant définis par rapport à un référentiel donné, des moyens pour indexer la première image 3D par rapport à la deuxième image 3D pour obtenir une troisième image 3D référencée dans ledit référentiel, des moyens pour réaliser une image dudit point dans ledit référentiel, et des moyens pour guider ledit point par rapport audit corps dans ledit référentiel au moyen de ladite troisième image 3D et de l'image dudit point.The present invention also relates to a device making it possible to implement the method defined above to guide the movement of at least one reference point relative to a body, characterized in that it comprises: means for producing a first 3D image of the body by means of a first radiation beam, means for producing a second 3D image of said body, this second 3D image being defined by a plurality of image points in finite numbers corresponding to sample points on the surface of said body, these sample points being defined with respect to a given reference frame, means for indexing the first 3D image with respect to the second 3D image to obtain a third 3D image referenced in said reference frame, means for producing an image of said point in said reference frame, and means for guiding said point relative to said body in said reference frame by means of said third 3D image and of the image of said point.
D'autres caractéristiques et avantages de l'invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif mais nullement limitatif, dans lesquels :Other characteristics and advantages of the invention will appear during the following description given with reference to the drawings annexed by way of illustration but in no way limitative, in which:
La figure 1 est le schéma synoptique de mise en œuvre du procédé selon l'invention pour guider le déplacement d'au moins un point de référence par rapport à un corps, etFIG. 1 is the block diagram of implementation of the method according to the invention for guiding the displacement of at least one reference point relative to a body, and
La figure 2 représente le schéma de principe d'un dispositif permettant de mettre en œuvre le procédé selon l'invention, dans une application dans le domaine dentaire.FIG. 2 represents the block diagram of a device making it possible to implement the method according to the invention, in an application in the dental field.
La présente invention concerne un procédé pour guider le déplacement d'au moins un point de référence Pr par rapport à un corps K qui trouve des applications avantageuses dans le domaine médical, et plus particulièrement dentaire. Un exemple de mise en œuvre du procédé est décrit ci-après dans une application dentaire pour implanter de façon très précise des dents artificielles au moyen de pivots ou analogues, étant bien entendu que ce procédé peut aussi s'appliquer sans aucune difficulté dans d'autres domaines d'application et quelle que soit la nature du corps K. Le schéma synoptique du procédé selon l'invention est représenté sur la figure 1.The present invention relates to a method for guiding the movement of at least one reference point P r with respect to a body K which finds advantageous applications in the medical field, and more particularly dental. An example of implementation of the method is described below in a dental application for very precisely implanting artificial teeth by means of pivots or the like, it being understood that this method can also be applied without any difficulty in other fields of application and whatever the nature of the body K. The block diagram of the method according to the invention is shown in FIG. 1.
Par référence à ce schéma, le procédé consiste à réaliser tout d'abord une première image 3D du corps K, image en trois dimensions (image I, figure 1), au moyen d'un premier faisceau de rayonnement. Dans le cas de l'application du procédé au domaine dentaire, la première image 3D est celle de la partie de la mâchoire 1 comprenant l'emplacement 2 de la dent à remplacer et l'ensemble des dents 3 qui se trouvent au voisinage de cet emplacement 2, ainsi que celle de la portion de l'os du maxillaire 4 qui porte ces dents 3 et cette première image 3D est obtenue au moyen d'au moins l'un des faisceaux de rayonnement suivants : faisceau de rayonnement X, faisceau de rayonnement lumineux, faisceau d'ultrasons ou analogues. Dans le mode de mise en œuvre illustré sur la figure 1 , le premier faisceau de rayonnement utilisé est un faisceau de rayons X (RAY.X) qui permet avantageusement de pénétrer dans l'émail et la dentine des dents, ainsi que dans l'os dans lequel sont implantées les dents.With reference to this diagram, the method consists first of all in producing a first 3D image of the body K, a three-dimensional image (image I, FIG. 1), by means of a first beam of radiation. In the case of the application of the method to the dental field, the first 3D image is that of the part of the jaw 1 comprising the location 2 of the tooth to be replaced and the set of teeth 3 which are in the vicinity of this location 2, as well as that of the portion of the jaw bone 4 which carries these teeth 3 and this first 3D image is obtained by means of at least one of the The following radiation beams: X-ray beam, light radiation beam, ultrasound beam or the like. In the embodiment illustrated in FIG. 1, the first radiation beam used is an X-ray beam (RAY.X) which advantageously makes it possible to penetrate into the enamel and the dentine of the teeth, as well as into the bone in which the teeth are implanted.
Une telle image 3D est obtenue d'une façon bien connue en elle-même. Elle peut être obtenue au moyen par exemple d'une source 5 de rayons X, figure 2, d'un scintillateur 6 qui reçoit les rayons X qui ont traversé le corps et qui les transforme en signaux lumineux, et d'un convertisseur 7, comme un capteur CCD ou analogue, qui convertit ces signaux lumineux en signaux électriques analogiques ou numériques. Ces signaux électriques sont ensuite traités au moyen d'un organe de traitement 8 commandé par un programmateur 28 de type ordinateur ou analogue, connu en lui-même, pour former une image vidéo 9 visualisée sur un écran vidéo 10 ou analogue. Le procédé consiste ensuite à réaliser (BRAS AR„ figure 1 ) une deuxième image 3D du corps (image II, figure 1), cette deuxième image 3D étant définie par une pluralité de points images en nombre fini correspondant à des points échantillons de la surface du corps K, ces points échantillons étant définis par rapport à un référentiel donné. Cette deuxième image 3D peut être obtenue de façon connue en elle-même, par exemple au moyen d'un bras de mesure poly-articulé de robot, schématiquement illustré en 12 sur la figure 2. Les signaux délivrés par le bras poly- articulé chaque fois qu'il est pointé sur un point échantillon de la surface du corps K sont appliqués sur une entrée de l'organe de traitement 8 qui les transforme en des signaux qui sont traités pour donner des points images, par exemple vidéo, qui, du fait de la structure du bras de robot 12, sont parfaitement déterminés et référencés par une adresse dans un référentiel R (par exemple en X, Y et Z), figure 2, par exemple lié au robot lui-même.Such a 3D image is obtained in a manner well known in itself. It can be obtained by means for example of a source 5 of X-rays, FIG. 2, of a scintillator 6 which receives the X-rays which have passed through the body and which transforms them into light signals, and of a converter 7, like a CCD sensor or the like, which converts these light signals into analog or digital electrical signals. These electrical signals are then processed by means of a processing member 8 controlled by a programmer 28 of the computer or similar type, known in itself, to form a video image 9 displayed on a video screen 10 or the like. The process then consists in producing (ARM AR „figure 1) a second 3D image of the body (image II, figure 1), this second 3D image being defined by a plurality of image points in finite number corresponding to sample points of the surface of the body K, these sample points being defined with respect to a given frame of reference. This second 3D image can be obtained in a manner known per se, for example by means of a poly-articulated robot measurement arm, schematically illustrated at 12 in FIG. 2. The signals delivered by the poly-articulated arm each once it is pointed at a sample point on the surface of the body K are applied to an input of the processing member 8 which transforms them into signals which are processed to give image points, for example video points, which, from the made of the structure of the robot arm 12, are perfectly determined and referenced by an address in a reference frame R (for example in X, Y and Z), FIG. 2, for example linked to the robot itself.
Quand cette deuxième image 3D a été obtenue, le procédé consiste (INDEX. figure 1) alors à indexer la première image 3D par rapport à la deuxième image 3D par exemple dans l'organe de traitement 8, figure 2, de façon connue en elle-même au moyen par exemple de logiciels de commande de déplacement d'images qui se trouvent couramment dans le commerce et qui permettent de déplacer sur un écran vidéo une image vidéo, en l'occurrence la première image 3D, pour la superposer à une autre image vidéo, en l'occurrence la deuxième image 3D, de façon que le maximum de points images des points échantillons se confondent avec les points images correspondants de la première image 3D. En théorie, trois points échantillons sont suffisants pour obtenir cette superposition, mais il est évident que le résultat sera plus facile à obtenir et plus fiable si le nombre de points échantillons est plus grand.When this second 3D image has been obtained, the method consists (INDEX. FIG. 1) then in indexing the first 3D image with respect to the second 3D image for example in the processing member 8, FIG. 2, in a manner known in it -even by means of software for controlling the movement of images which are currently commercially available and which make it possible to move a video image, in this case the first 3D image, on a video screen, in order to superimpose it on another video image, in this case the second 3D image, so that the maximum of image points of the sample points merge with the corresponding image points of the first 3D image. In theory, three sample points are sufficient to obtain this superposition, but it is obvious that the result will be easier to obtain and more reliable if the number of sample points is greater.
Quand ces deux première et deuxième images 3D sont superposées, on obtient une troisième image 3D (image III, figure 1) identique à la première mais référencée dans le référentiel R défini ci-dessus, chacun de ses points étant défini par son adresse dans ce référentiel.When these two first and second 3D images are superimposed, a third 3D image is obtained (image III, FIG. 1) identical to the first but referenced in the repository R defined above, each of its points being defined by its address in this repository.
Le procédé consiste ensuite à réaliser une image du point Pr dans le même référentiel R, (BRAS MAN., figure 1), par exemple avec un bras articulé de robot 13 du même type que celui décrit ci-dessus, qui est visualisée dans l'image 9 sur l'écran vidéo 10, figure 2. A ce stade du procédé, il est facile de guider le point Pr par rapport au corps K dans le même référentiel R au moyen de la troisième image 3D et de l'image du point Pr qui se trouvent combinées dans la même image 9 sur l'écran vidéo 10, comme représenté sur la figure 2.The method then consists in making an image of the point Pr in the same frame of reference R, (ARM MAN., FIG. 1), for example with an articulated robot arm 13 of the same type as that described above, which is visualized in the image 9 on the video screen 10, FIG. 2. At this stage of the process, it is easy to guide the point P r relative to the body K in the same frame of reference R by means of the third 3D image and the image from point P r which are combined in the same image 9 on the video screen 10, as shown in FIG. 2.
Dans cette représentation, le corps K est la mâchoire 1 d'un patient et le point Pr est par exemple un point lié à la mèche 16 de perçage de l'os du maxillaire 4 pour préparer l'implantation d'une dent de remplacement à l'emplacement 2. La mèche 16 étant liée à l'organe de traitement 8 par le bras articulé 13, il est facile au praticien de la positionner exactement à l'emplacement voulu 2 du corps K, par une simple observation de l'image 9 sur l'écran vidéo sans être obligé d'observer in situ le déplacement de cette mèche elle-même.In this representation, the body K is the jaw 1 of a patient and the point P r is for example a point linked to the drill bit 16 for piercing the jaw bone 4 to prepare the implantation of a replacement tooth at location 2. The drill bit 16 being linked to the treatment member 8 by the articulated arm 13, it is easy for the practitioner to position it exactly at the desired location 2 of the body K, by a simple observation of the image 9 on the video screen without having to observe in situ the movement of this wick itself.
Le procédé décrit ci-dessus peut être mis en œuvre, à la condition que le corps K soit immobile par rapport au référentiel R.The method described above can be implemented, provided that the body K is stationary relative to the reference frame R.
Il est cependant bien évident que, dans le cas d'un corps Ktel que la dentition d'un patient, ce dernier ne peut jamais être rigoureusement immobile. En conséquence, pour compenser les déplacements dus aux mouvements du patient et connaître constamment la position du corps K par rapport au référentiel R, il est très avantageux que le procédé selon l'invention consiste en outre à indexer le corps K par rapport au référentiel R. Aussi, le dispositif permettant de mettre en œuvre le procédé selon l'invention peut comporter en outre des moyens pour indexer le corps K par rapport au référentiel R. Ces moyens peuvent être de tout type, par exemple un bras 22 du même type que ceux qui sont référencés 12 ou 13. Cette indexation permet de positionner la troisième image 3D en fonction des mouvements du corps K et d'obtenir à tout instant, sur l'écran 10, une parfaite corrélation entre cette troisième image 3 D et la position réelle du patient.It is however quite obvious that, in the case of a body Ktel as the dentition of a patient, the latter can never be rigorously immobile. Consequently, to compensate for the displacements due to the movements of the patient and to constantly know the position of the body K relative to the reference frame R, it is very advantageous that the method according to the invention also consists in indexing the body K relative to the reference frame R . Also, the device making it possible to implement the method according to the invention may further comprise means for indexing the body K relative to the reference frame R. These means can be of any type, for example an arm 22 of the same type as those which are referenced 12 or 13. This indexing makes it possible to position the third 3D image as a function of the movements of the body K and to obtain at all times, on the screen 10, a perfect correlation between this third 3D image and the real position of the patient.
Le procédé décrit ci-dessus donne de bons résultats en lui-même. Cependant, dans le cas où le premier faisceau de rayonnement est un faisceau de rayons X, l'image obtenue peut présenter des parties sombres ou des images parasites dues notamment à la diffusion des rayons X qui en limitent sa qualité. Tel est le cas de la première image 3D.The method described above gives good results in itself. However, in the case where the first radiation beam is an X-ray beam, the image obtained may have dark parts or parasitic images due in particular to the scattering of X-rays which limit its quality. This is the case with the first 3D image.
En effet, il n'est pas inhabituel que les rayons X utilisés pour la réalisation de la première image 3D rencontrent, par exemple dans une dentition ou analogue, des matériaux opaques aux rayons X, par exemple des amalgames, céramiques ou analogues, qui s'opposent à leur pénétration et qui les réfléchissent et les diffusent dans l'espace environnant. La première image 3D obtenue comporte donc souvent des images parasites connues des techniciens sous le terme d'artefacts.Indeed, it is not unusual for the X-rays used for the production of the first 3D image to encounter, for example in dentition or the like, materials opaque to the X-rays, for example amalgams, ceramics or the like, which are s oppose their penetration and which reflect and diffuse them into the surrounding space. The first 3D image obtained therefore often includes parasitic images known to technicians under the term of artifacts.
Aussi, de façon avantageuse, le procédé consiste, en plus des phases décrites ci-dessus, à réaliser une quatrième image 3D du corps K au moyen d'un second faisceau de rayonnement au moins partiellement réfléchissant sur la surface du corps.Also, advantageously, the method consists, in addition to the phases described above, in producing a fourth 3D image of the body K by means of a second radiation beam at least partially reflecting on the surface of the body.
Cependant, notamment lorsque la partie du corps K, par exemple une partie 1 , 3, 21 , 4 de la dentition d'un patient, qui doit être traitée est difficilement accessible, la quatrième image 3D (image IV, figure 1) peut être réalisée indirectement sur une empreinte en creux (technique en négatif) de cette partie de dentition, réalisée préalablement (CAM vide., figure 1). Il est aussi possible de réaliser la quatrième image 3D sur un moulage en plein (technique en positif) obtenu à partir de l'empreinte en creux. Avantageusement, cette quatrième image 3D est obtenue par balayage de la partie de la dentition à traiter au moyen d'un faisceau de rayonnement lumineux, par exemple celui qui est délivré par un générateur laser 11 ou analogue. Cette technique dénommée par les techniciens « image obtenue par scanner » est bien connue en elle-même et ne sera pas plus amplement décrite ici. Le procédé consiste alors à traiter la première image 3D par la quatrième image 3D pour obtenir une première image 3D corrigée de ses artefacts (COR, figure 1). De cette façon, la première image 3D corrigée de ses artefacts visualisée sur l'écran vidéo 10 représente parfaitement et en volume, le corps K qui doit être analysé, c'est-à-dire dans le cas de l'application citée à titre d'exemple, toute la partie de la dentition concernée pour l'implantation d'une dent de remplacement, cette représentation du corps K comportant un nombre minimum de défauts qui pourraient troubler l'observation du praticien.However, in particular when the part of the body K, for example a part 1, 3, 21, 4 of the dentition of a patient, which must be treated is difficult to access, the fourth 3D image (image IV, FIG. 1) can be carried out indirectly on a hollow impression (technique in negative) of this portion of dentition, carried out beforehand (empty CAM, Figure 1). It is also possible to make the fourth 3D image on a full molding (positive technique) obtained from the hollow imprint. Advantageously, this fourth 3D image is obtained by scanning the part of the dentition to be treated by means of a beam of light radiation, for example that which is delivered by a laser generator 11 or the like. This technique called by technicians "image obtained by scanner" is well known in itself and will not be described more fully here. The method then consists in processing the first 3D image with the fourth 3D image to obtain a first 3D image corrected for its artifacts (COR, FIG. 1). In this way, the first 3D image corrected of its artefacts displayed on the video screen 10 represents perfectly and in volume, the body K which must be analyzed, that is to say in the case of the application cited as for example, all the part of the dentition concerned for the implantation of a replacement tooth, this representation of the body K comprising a minimum number of defects which could disturb the observation of the practitioner.
Il est cependant précisé que, pour obtenir la quatrième image 3D d'un corps qui est par exemple recouvert d'une couche superficielle d'une matière comme la chair 21 de la gencive, il est avantageux d'utiliser un rayonnement qui traverse cette matière mais qui est réfléchi par le matériau constituant principal du corps, par exemple l'os du maxillaire. Dans le domaine d'application cité ci-dessus à titre d'exemple, un tel rayonnement est par exemple celui donné par une source d'ultrasons 18.It is however specified that, to obtain the fourth 3D image of a body which is for example covered with a surface layer of a material like the flesh 21 of the gum, it is advantageous to use a radiation which crosses this material but which is reflected by the main constituent material of the body, for example the jaw bone. In the field of application cited above by way of example, such radiation is for example that given by an ultrasound source 18.
Ainsi, dans l'exemple d'application avantageux décrit ci-dessus, la quatrième image 3D peut être obtenue in situ, au moyen de deux faisceaux, un faisceau de rayonnement lumineux pour la couronne des dents et un faisceau d'ultrasons pour le collet des dents et l'os du maxillaire. L'homme du métier connaît les types de capteurs nécessaires pour recevoir les rayons lumineux réfléchis (capteur 19) ou les ultrasons réfléchis (capteur 20) et pour délivrer des signaux qui seront transmis à l'organe de traitement 8 commandé par le programmateur 28.Thus, in the advantageous example of application described above, the fourth 3D image can be obtained in situ, by means of two beams, a beam of light radiation for the crown of the teeth and a beam of ultrasound for the collar. teeth and jaw bone. Those skilled in the art know the types of sensors necessary to receive the reflected light rays (sensor 19) or the reflected ultrasound (sensor 20) and to deliver signals which will be transmitted to the processing unit 8 controlled by the programmer 28.
Quand cette quatrième image 3D est obtenue à partir d'une empreinte ou analogue, elle peut, elle aussi, présenter des défauts. En conséquence, de façon avantageuse, il est possible de vérifier cette quatrième image 3D au moyen de la deuxième, et éventuellement de lui faire subir des corrections en fonction de la définition de cette deuxième image qui, elle, est certaine, puisque obtenue directement à partir du corps lui-même.When this fourth 3D image is obtained from an imprint or the like, it too may have defects. Consequently, advantageously, it is possible to verify this fourth 3D image by means of the second, and possibly to subject it to corrections as a function of the definition of this second image which, for its part, is certain, since it is obtained directly from from the body itself.
Le praticien qui veut implanter une dent peut visualiser, sur la troisième image 3D, l'axe 15 suivant lequel devra être implantée la dent de remplacement, axe qu'il a défini de façon parfaite par rapport aux autres dents 3 et à l'os du maxillaire 4. Il peut ensuite positionner la mèche 16 de la perceuse 14 et contrôler son déplacement de façon que l'axe de la mèche soit parfaitement confondu avec l'axe d'implantation 15 et le demeure constamment au fur et à mesure qu'elle pénètre dans l'os pour la réalisation de l'avant-trou 17. Cette opération est toujours possible, même si le patient bouge car, de par son indexation dans le même référentiel R via les moyens 22, la troisième image se déplace en corrélation avec les mouvements du patient, ce qui permet au praticien de pouvoir constamment positionner la mèche 16 de façon correcte par rapport au patient.The practitioner who wants to implant a tooth can visualize, on the third 3D image, the axis 15 along which the replacement tooth should be implanted, axis which he has defined perfectly in relation to the other teeth 3 and to the bone. of the jaw 4. He can then position the drill bit 16 of the drill 14 and control its movement so that the axis of the drill bit is perfectly coincident with the implantation axis 15 and remains constant as and when it enters the bone for the realization of the pilot hole 17. This operation is always possible, even if the patient moves because, by its indexing in the same frame of reference R via the means 22, the third image moves in correlation with the movements of the patient, this which allows the practitioner to be able to constantly position the wick 16 correctly relative to the patient.
L'exemple donné ci-dessus est une application au domaine dentaire, mais il est bien entendu qu'un tel procédé trouve des applications tout aussi avantageuses, par exemple, dans le domaine de la chirurgie ou de la micro-chirurgie notamment par endoscopie. The example given above is an application in the dental field, but it is understood that such a method finds equally advantageous applications, for example, in the field of surgery or microsurgery in particular by endoscopy.

Claims

REVENDICATIONS
1. Procédé pour guider le déplacement d'au moins un point de référence (Pr) par rapport à un corps (K), consistant : à réaliser une image 3D à partir dudit corps (K) dans un référentiel donné, à réaliser une image dudit point de référence (Pr) dans ledit référentiel, et à guider ledit point de référence (Pr) par rapport audit corps dans ledit référentiel au moyen de ladite image 3D réalisée à partir dudit corps et de l'image dudit point de référence (Pr), caractérisé par le fait que ladite image 3D réalisée à partir dudit corps (K) dans le référentiel donné est obtenue : en réalisant, d'une part une première image 3D du corps (K) au moyen d'un premier faisceau de rayonnement, et d'autre part une deuxième image 3D dudit corps (K), cette deuxième image 3D étant définie par une pluralité de points images en nombre fini correspondant à des points échantillons de la surface dudit corps, ces points échantillons étant définis par rapport au référentiel donné, puis en indexant la première image 3D par rapport à la deuxième image 3D pour obtenir une troisième image 3D référencée dans le référentiel donné, cette dite troisième image 3D étant l'image 3D réalisée à partir dudit corps.1. Method for guiding the movement of at least one reference point (Pr) relative to a body (K), consisting of: producing a 3D image from said body (K) in a given frame of reference, producing an image of said reference point (Pr) in said reference frame, and in guiding said reference point (Pr) relative to said body in said reference frame by means of said 3D image produced from said body and of the image of said reference point (Pr ), characterized by the fact that said 3D image produced from said body (K) in the given frame of reference is obtained: by producing, on the one hand, a first 3D image of the body (K) by means of a first radiation beam , and on the other hand a second 3D image of said body (K), this second 3D image being defined by a plurality of image points in finite number corresponding to sample points on the surface of said body, these sample points being defined with respect to the ref given essential, then by indexing the first 3D image with respect to the second 3D image to obtain a third 3D image referenced in the given frame of reference, this so-called third 3D image being the 3D image produced from said body.
2. Procédé selon la revendication 1 , caractérisé par le fait que ledit premier faisceau de rayonnement est au moins l'un des faisceaux de rayonnement suivants : faisceau de rayonnement X, faisceau de rayonnement lumineux, faisceau d'ultrasons.2. Method according to claim 1, characterized in that said first radiation beam is at least one of the following radiation beams: X-ray beam, light radiation beam, ultrasound beam.
3. Procédé selon l'une des revendications 1 et 2, caractérisé par le fait que ladite deuxième image 3D est obtenue au moyen d'un bras de mesure poly-articulé de robotique.3. Method according to one of claims 1 and 2, characterized in that said second 3D image is obtained by means of a poly-articulated measurement arm of robotics.
4. Procédé selon l'une des revendications 1 à 3, caractérisé par le fait qu'il consiste à réaliser lesdites première, deuxième et troisième images 3D sous forme vidéographique de façon qu'elles soient aptes à être visualisées sur un écran vidéo. 4. Method according to one of claims 1 to 3, characterized in that it consists in producing said first, second and third 3D images in videographic form so that they are capable of being viewed on a video screen.
5. Procédé selon l'une des revendications 1 à 4, caractérisé par le fait qu'il consiste à réaliser une quatrième image 3D dudit corps au moyen d'un second faisceau de rayonnement au moins partiellement réfléchissant sur la surface dudit corps, et à traiter la première image 3D par la quatrième image 3D pour obtenir une première image 3D corrigée de ses artefacts.5. Method according to one of claims 1 to 4, characterized in that it consists in producing a fourth 3D image of said body by means of a second radiation beam at least partially reflecting on the surface of said body, and process the first 3D image with the fourth 3D image to obtain a first 3D image corrected for its artifacts.
6. Procédé selon la revendication 5, caractérisé par le fait qu'il consiste à réaliser la quatrième image 3D à partir d'une empreinte dudit corps, ladite empreinte étant réalisée selon l'une des techniques suivantes : "technique en négatif " et "technique en positif.6. Method according to claim 5, characterized in that it consists in producing the fourth 3D image from an imprint of said body, said imprint being produced according to one of the following techniques: "negative technique" and " technical in positive.
7. Procédé selon l'une des revendications 5 et 6, caractérisé par le fait qu'il consiste à vérifier la quatrième image 3D à partir de la deuxième image 3D.7. Method according to one of claims 5 and 6, characterized in that it consists in verifying the fourth 3D image from the second 3D image.
8. Procédé selon l'une des revendications 5 à 7, caractérisé par le fait que le second faisceau de rayonnement au moins partiellement réfléchissant sur la surface dudit corps est au moins l'un des faisceaux suivants : faisceau de rayonnement lumineux, faisceau d'ultrasons.8. Method according to one of claims 5 to 7, characterized in that the second beam of radiation at least partially reflecting on the surface of said body is at least one of the following beams: beam of light radiation, beam of ultrasound.
9. Procédé selon l'une des revendications 1 à 8, caractérisé par le fait qu'il consiste à indexer ledit corps (K) par rapport audit référentiel (R).9. Method according to one of claims 1 to 8, characterized in that it consists in indexing said body (K) relative to said repository (R).
10. Dispositif permettant de mettre en œuvre le procédé en accord avec l'une des revendications précédentes, caractérisé par le fait qu'il comporte: des moyens (5, 6, 7, 8, 9, 10) pour réaliser une première image 3D du corps10. Device for implementing the method in accordance with one of the preceding claims, characterized in that it comprises: means (5, 6, 7, 8, 9, 10) for producing a first 3D image from the body
(K) au moyen d'un premier faisceau de rayonnement, des moyens (8, 12, 10) pour réaliser une deuxième image 3D dudit corps (K), cette deuxième image 3D étant définie par une pluralité de points images en nombre fini correspondant à des points échantillons de la surface dudit corps (K), ces points échantillons étant définis par rapport à un référentiel donné (R), des moyens (8) pour indexer la première image 3D par rapport à la deuxième image 3D pour obtenir une troisième image 3D référencée dans ledit référentiel (R), des moyens (8, 13, 10) pour réaliser une image dudit point (Pr) dans ledit référentiel (R), et des moyens (13, 14, 15) pour guider ledit point (Pr) par rapport audit corps (K) dans ledit référentiel (R) au moyen de ladite troisième image 3D et de l'image dudit point (Pr).(K) by means of a first radiation beam, means (8, 12, 10) for producing a second 3D image of said body (K), this second 3D image being defined by a plurality of image points in corresponding finite number at sample points on the surface of said body (K), these sample points being defined with respect to a given frame of reference (R), means (8) for indexing the first 3D image with respect to the second 3D image to obtain a third 3D image referenced in said reference frame (R), means (8, 13, 10) for producing an image of said point (Pr) in said reference frame (R), and means (13, 14, 15) for guiding said point (Pr) relative to said body (K) in said reference frame (R) by means of said third 3D image and of the image of said point (Pr).
11. Dispositif selon la revendication 10, caractérisé par le fait qu'il comporte en outre : des moyens (8, 10, 11, 19, 18, 20) pour réaliser une quatrième image 3D dudit corps (K) au moyen d'un second faisceau de rayonnement au moins partiellement réfléchissant sur la surface dudit corps, et des moyens (8) pour traiter la première image 3D par la quatrième image 3D pour obtenir une première image 3D corrigée de ses artefacts. 11. Device according to claim 10, characterized in that it further comprises: means (8, 10, 11, 19, 18, 20) for producing a fourth 3D image of said body (K) by means of a second radiation beam at least partially reflecting on the surface of said body, and means (8) for processing the first 3D image with the fourth 3D image to obtain a first 3D image corrected for its artifacts.
PCT/FR2001/001355 2001-05-04 2001-05-04 Method and device for guiding the movement of at least one reference point in relation to a body WO2002089692A1 (en)

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