CN101006942B - 逐渐移位牙齿的方法 - Google Patents

逐渐移位牙齿的方法 Download PDF

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CN101006942B
CN101006942B CN2007100054694A CN200710005469A CN101006942B CN 101006942 B CN101006942 B CN 101006942B CN 2007100054694 A CN2007100054694 A CN 2007100054694A CN 200710005469 A CN200710005469 A CN 200710005469A CN 101006942 B CN101006942 B CN 101006942B
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马哈马德·齐蒂
阿波斯托洛斯·勒里奥斯
布莱恩·弗赖伯格
凯尔西·沃思
理查德·里奇利
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/08Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/46Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with special arrangements for interfacing with the operator or the patient
    • A61B6/461Displaying means of special interest
    • A61B6/466Displaying means of special interest adapted to display 3D data
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • A61C9/004Means or methods for taking digitized impressions
    • 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00Dental prostheses; Making same
    • A61C13/0003Making bridge-work, inlays, implants or the like
    • A61C13/0004Computer-assisted sizing or machining of dental prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/002Orthodontic computer assisted systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00Impression cups, i.e. impression trays; Impression methods
    • A61C9/004Means or methods for taking digitized impressions
    • A61C9/0046Data acquisition means or methods
    • A61C9/008Mechanical means or methods, e.g. a contact probe moving over the teeth

Abstract

一种重新定位牙齿的装置,它包括许多单独的器械。这些器械设计成能逐次放在患者的牙齿上,并且使这些牙齿逐渐从一个原始牙齿布局,通过许多中间牙齿布局移动到一个最后牙齿布局。这种器械系统通常在治疗开始时设计出来,因此,患者不必让专业治疗人员来完成治疗过程的每一个逐次的步骤,自己就能进行治疗。

Description

逐渐移位牙齿的方法
本申请是1997年10月8日提交的美国专利申请No.08/947,080的后续申请,而后者又要求了1997年6月20日提交的美国专利申请No.60/050,342的优先权。以上两个申请所公开的全部内容都被引入作为本申请的参考文献。
本申请是申请日为1998年6月19日、申请号为98806354.9、发明名称为“逐渐移位牙齿的方法和装置”的中国专利申请的分案申请。该中国专利申请已于2006年11月24日被授权。
发明背景
1.发明领域
本发明总体上涉及正牙学技术领域。更具体地说,本发明涉及一种使牙齿从原始牙齿布局逐渐移位到最后牙齿布局的方法和装置。
为了美观或其他理由而重新定位牙齿通常是用戴上一般称为“牙托”的用具来实现的。这种牙托包括各种器械,例如:托架、拱形钢丝、连线和O形圈。把这些器具安装在患者的牙齿上是冗长而费时的事情,需要多次会见主治的牙医。因此,传统的正牙治疗限制了正牙医生治疗患者的数量,并且正牙治疗的费用十分昂贵。
在把牙托固定在患者的牙齿上之前,一般至少要与正牙医生、牙医和/或X光照相室约见一次,以便取得患者牙齿和颚部的X光透视和相片。在初次会见时,或者也可能在以后会见时,一般还要制作一付患者牙齿的蛋白藻蛋白酸盐模子。这种模子提供了患者牙齿的模型,正牙医生可以将X光透视和照相与这种模型结合起来提出一个治疗方案。然后,在把牙托安装到患者的牙齿上期间,正牙医生一般还要诊治一次或多次。
在第一次安装牙托的诊治中,最初要用弱酸处理牙齿的表面。这种酸要选择的最主要性能是要粘结在牙齿上的托架和箍圈与牙齿表面的粘结性能。上述托架和箍圈的作用是用作以后增加上去的器械的紧固件。在酸处理步骤之后,用适当的粘结材料把托架和箍圈粘结在患者的牙齿上。在粘结固化之前,不要施加产生力量的器具。因此,正牙医生通常要安排一次以后的预约,以保证托架和箍圈能良好地粘结在牙齿上。
在一组传统的牙托上施加力量的主要器械是拱形钢丝(archwire)。这种拱形钢丝是有弹性的,利用托架上的窄缝固定在托架上。这种拱形钢丝把许多托架联系在一起,并对其施加力量,以便经过一段时间之后使牙齿移位。扭转钢丝或者合成橡胶的‘O’形圈常常用于加强拱形钢丝在托架上的固定。在正牙技术领域中,把拱形钢丝固定在托架上常常称为“绑扎”,而在这种工序中所使用的钢丝则称为“绑扎线”。合成橡胶‘O’形圈则称为“塑料”。
拱形钢丝就位后还要定期到正牙医生处就诊,这时,要安装各种具有能产生不同力量的性能的拱形钢丝,或者更换或拉紧已有的绑扎线。一般,这种就诊是预约的,每3-6周一次。
如上所述,使用传统的牙托是很漫长而费时的过程,需要多次到正牙医生处就诊。此外,从患者的观点来说,使用牙托既难看又不舒服,有感染的危险,还使得刷牙、剔牙和其他牙科卫生处理做起来很困难。
为此,就很需要提供其它的可替换的牙齿重新定位的方法和装置。这种方法和装置应该是经济的,特别是应该减少正牙医生在为每一个患者进行策划和照料时所耗费的时间。这些方法和装置还应该更容易为患者所接受,特别是应该做到就诊的次数较少,比较舒服,感染的可能性少,并且更便于日常的牙齿卫生保养。以下描述的本发明的方法和装置至少能达到以上所述的目的中的一部分。
2.背景技术
凯斯令(Kesling)在Am.J.Orthod.Oral.Surg.31:297-304(1945)&32:285-293(1946)中公开了用于完全正牙治疗的牙齿定位器。瓦伦克(Warunek)等人在(1989)J.Clin.Orthod.23:694-700中描述了全面调整患者牙齿的位置用的硅树脂定位器。路易斯安娜州70125,新奥尔良市的Raintree Essix公司和明尼苏达州55902,罗切斯特市的Tru-Tain塑料公司推出了市售的用于精整和保持牙齿布局的透明塑料保持器。在美国专利No.5,186,623;5,059,118;5,055,039;5,035,613;4,856,991;4,798,534;4,755,139中描述了正牙定位器的制造方法。
其他描述制造和使用牙科定位器的出版物有:克里曼(Kleemann)和强生(Janssen)的(1996)J.Clin.Orthodon.30:673-680;库尔顿(Cureton)的(1996)J.Clin.Orthodon.30:390-395;切庞(Chiappone)的(1980)J.Clin.Orthodon.14:121-133;希立戴(Shilliday)的(1971)Am.J.Orthodontics59:596-599;威尔斯(Wells)的(1970)Am.J.Orthodontics 58:351-366;以及科廷丰(Cottingham)的(1969)Am.J.Orthodontics 55:23-31。
库罗达(Kuroda)等人在(1996)Am.J.Orthodonticsl10:365-369中描述了一种用激光扫描石膏浇铸件以产生该浇铸件的数字影象的方法。亦见美国专利No.5,605,459。
授予奥莫科(Ormco)公司的美国专利No.5,533,895;5,474,448;5,454,717;5,447,432;5,431,562;5,395,238;5,368,478;5,139,419中描述了为设计正牙器械用的处理数字影象的方法。
美国专利No.5,011,405描述了一种用数字显示牙齿影象,并为正牙治疗确定最佳托架定位的方法。在美国专利No.5,338,198中公开了用激光扫描模制的牙齿以产生立体模型的技术。在美国专利No.5,452,219中描述了用激光扫描牙齿模型和研磨牙齿模型的方法。在美国专利No.5,607,305和5,587,912中描述了牙齿外形的数字计算机处理法。在美国专利No.5,342,202和5,340,309中公开了用计算机显示颚部的数字影象的技术。其他有关的美国专利文献有:5,549,476;5,382,164;5,273,429;4,936,862;3,860,803;3,660,900;5,645,421;5,055,039;4,798,534;4,856,991;5,035,613;5,059,118;5,186,623;4,755,139。
发明概述
本发明提供了一种经过改进的,用于将牙齿从原始牙齿布局重新定位到最后牙齿布局的方法和装置。重新定位是用这样一种装置来实现的,这种装置有一系列设计成能把牙齿容纳在一个空腔内的器械,并用一系列步骤逐渐使各个牙齿重新定位。以上所述的一系列步骤至少是三个逐次的步骤,一般包括至少四个逐次的步骤,常常包括至少十个步骤,有时要包括至少25个步骤,而且偶然可能包括40个或更多的步骤。最经常的是,这种方法和装置用10个到25个逐次的步骤来使牙齿重新定位,虽然在复杂的情况下有许多患者的牙齿要用40个或者更多的步骤。逐次使用一系列器械可以把每一种器械设计成以很小的移位量移位每一颗牙齿,一般小于2mm,优选是小于1mm,最好是小于0.5mm。这些限制是利用单独一种器械时,在一颗牙齿上的任何一点上的最大线性移位量。当然,由逐次的器械所形成的移位对于任何一颗特定的牙齿来说常常是不相同的。因此,由于使用一种器械的结果,一颗牙齿上的某一点可以移位一个特定的距离,然后,用下一个器械再使这一点在相同或不同的方向上移位不同的距离。
单个器械通常是一个具有能在内部容纳牙齿的空腔的聚合物壳体,一般用下述的方法模制而成。每一个单个器械通常是这样设计的,即,它的容纳牙齿的空腔的几何形状与该器械所要达到的牙齿的中间布局或最后位置相适应。这就是说,当患者第一次戴上这个器械时,全部牙齿中的某些牙齿将与该器械空腔的未变形的几何形状错位。但是,这种器械有足够的弹性去适应或符合错位的牙齿,并且将对这颗错位的牙齿施加足够的弹性力量,以便使这颗牙齿重新定位到这个治疗步骤所要达到的中间布局或最后位置。
按照本发明的装置包括至少一个第一器械,该第一器械具有选定的、使患者的牙齿从原始牙齿布局重新定位到第一中间布局上的几何形状,在第一中间布局的基础上将逐渐重新定位各牙齿。这种装置还包括至少一个中间器械,它具有选定的、逐渐使牙齿从上述第一中间布局重新定位到一个或几个逐次的中间布局上的几何形状。这种装置还包括一个最后的器械,它具有选定的,逐渐使牙齿从最后的中间布局重新定位到所要求的最后牙齿布局上的几何形状。在有些情况下,需要把最后的一个或几个器械做成使得最后的牙齿布局“矫枉过正”,这一点下面还要详细讨论。
如将要在下面结合本发明的方法更详细地描述的,这种装置是可以设计的,而且全部单个器械在治疗一开始就制造好,这样,就能把这些器械作为单独的一套器械或一套装置提供给患者。器械的使用次序要清楚地标明(例如用逐次的数字),这样,患者就能够按照正牙医生或其他治疗专业人员所规定的频率把这些器械套在牙齿上。与使用牙托不同,这种患者不需要每次都到专业治疗人员那里去,就能够进行治疗上的调节。虽然患者一般还需要周期性地去专业治疗人员那里,以确认治疗是按照原来的计划进行着,但确不需要每次都到专业人员那里去进行调节,这样就能以更多但更小的连续的步骤进行治疗,同时还减少了专业治疗人员为每一个患者所花费的时间。此外,由于患者有能力自己使用这种更舒服、看不见、并且可以拆卸的聚合物的外壳器械,因而大大改进了患者的配合、舒适和满意的程度。
按照本发明的一种方法,在患者的嘴里放置了一系列逐渐定位的调节器械,以使患者的牙齿从原始的牙齿布局重新定位到最后的牙齿布局。非常方便,这种器械不是固定的,患者可以在治疗过程中随时放置或重新放置器械。在一系列器械中的第一个器械要选择这样的几何形状,它能把牙齿从原始的牙齿布局重新定位到第一中间布局上。在接近或者到达第一中间布局之后,再逐次地把一个或多个附加的(中间的)器械放置在牙齿上,此时,这种附加的器械所选择的几何形状要能逐渐使牙齿从第一中间布局逐次重新定位到若干个中间布局上。当把最后一个器械放入患者的嘴里时,治疗就可以结束了,此时,这个最后的器械所选定的几何形状能逐渐把牙齿从最后一个中间布局重新定位到最后的牙齿布局上。在一系列器械中的最后一个器械或者最后几个器械要选择这样的形状,使得牙齿的位置过度地矫证,即,要有一个使各个牙齿移位到超出选定的“最后”位置的几何形状(如果完全到位的话)。为了在重新定位的方法终止之后抵消潜在的反弹,这种过度矫正是必要的,也就是说,允许各个牙齿会向着矫正之前的位置稍稍移位。过度矫正还有利于加快矫正的速度,即,使一个器械的几何形状的位置超过所要求的中间或最后位置,各颗牙齿就会以更快的速度向这个位置移位。在这种情况下,可以在牙齿到达由这个或这几个最后的器械所确定的位置之前就结束治疗。上述方法一般包括放置至少两个附加的器械,常常要放置至少10个附加器械,有时要放置至少25个附加器械,偶尔要放置至少40个或更多的附加器械。当牙齿接近(在预先选定的公差范围内)或者已经到达这一治疗阶段的最后目标位置时,就要更换为后续的器械,一般是在2-20天的间隔范围内更换,经常是在5-10天的间隔范围内。
有可能常常需要在牙齿实际上到达该治疗阶段的“最后”位置之前就更换器械。应该理解,当牙齿逐渐重新定位,并接近由一个特定的器械所确定的几何形状时,在这颗牙齿上的重新定位的力将大大地减小。因此,及早在牙齿还只有被前一个器械部分定位时,就用后一个器械来更换前一个器械,就能缩短整个治疗的时间。因此,FDDS实际上能代表最后牙齿布局的过度矫正。这样,既加快了治疗,又能抵消患者的反弹。
一般,转换到下一个器械要根据很多因素。最简单的方式是可以按照预定的日程表或按照固定的时间间隔(即每个器械的天数)来更换,这个间隔是在一开始根据预期的要求或者典型患者的反应确定的。换一种方式,也可以把具体患者的反应考虑在内,例如,当患者不再感觉到目前这个器械施加在牙齿上的压力时,即,患者很容易把这个器械戴在他的牙齿上,而且牙齿上没有受到什么压力或者不舒服时,就可以换用下一个器械。在有些情况下,对于那些牙齿的反应很快的患者,专业治疗人员也可以决定跳过一个或者几个中间器械,即,减少使用的器械的总数,使它少于最初确定的数量。这样,就能缩短特定患者所需要的整个治疗时间。
另一方面,本发明的方法是利用若干器械来重新定位牙齿,这种器械包括带有空腔的聚合物外壳,空腔的形状做成能容纳牙齿,并弹性地重新定位牙齿,从而产生最后的牙齿布局。本发明还提供了这种方法的改进型,它在治疗一开始就确定至少三个上述器械的几何形状,患者要逐次戴这三个器械,以便把牙齿从原始的牙齿布局重新定位到最后的牙齿布局上。优选地,在开始时至少确定四个几何形状,常常是至少10个几何形状,经常是至少25个几何形状,有时候是40个或更多的几何形状。如上所述,一般,由每一个后续几何形状的空腔所确定的牙齿布局与由前一个几何形状的空腔所确定的牙齿布局的差别不大于2mm,优选不大于1mm,最好是不大于0.5mm。
本发明的又一个方面是提供用来产生一组代表最后的牙齿布局的数字数据组的方法。这种方法包括:提供一组代表原始牙齿布局的原始数据组,并呈现出根据这一组原始数据的可视影象。然后,处理这个可视影象,在该可视影象中重新定位各个牙齿。然后,产生一组最后的数字数据集,这一组数据代表具有在可视影象中显示出来的重新定位的牙齿的最后牙齿布局。原始数字数据集可以很方便地用现有技术来提供,包括数字化X射线影象,由计算机辅助的层析X射线扫描(CAT扫描)所产生的影象,由磁谐振造象(MRI)所产生的影象等等。优选地,这种影象是立体影象,而数字化则可以用常规技术来完成。一般,这样来提供原始数字数据集,即采用常规技术制作一个患者在治疗之前的牙齿的石膏铸件,然后,对所制成的石膏铸件用激光或其他扫描设备进行扫描,产生一个患者牙齿的石膏铸件的高分辨率的数字图像。使用石膏铸件是最佳选择,因为它不必让患者暴露在X射线下,或者让患者忍受不愉快的MRI扫描。
在一个优选实施例中,也可以用标准的方法取得一个患者的蜡咬印。这种蜡咬印能让患者的上、下牙齿形状的石膏铸件放在互相咬合的中心位置上。然后,对这一对铸件扫描,以提供在这个位置上的颚部相对位置的信息。然后,把这种信息合并入两个拱形的IDDS中。
一旦获得了数字数据集,就能在装备有计算机辅助设计软件的合适的计算机系统上显示并处理影象。这一点下面还要更详细的描述。影象的处理通常包括确定各个牙齿中的至少一些牙齿的边界,并借助于通过计算机处理上述影象,使牙齿的影象相对于颚部和其他牙齿移位。本发明还提供了用于检测牙齿齿尖的信息的方法。影象的处理可以完全凭主观进行,即,使用者可以单凭对影象的观察,以一种审美和/或治疗所要求的方式,简单地重新定位牙齿。或者,上述计算机系统可以设置一些规则和算法,来帮助使用者重新定位牙齿。在有些情况下,有可能提供以完全自动的方式,即不用使用者介入的方式,来重新定位牙齿的规则和算法。一旦各个牙齿重新定好位之后,就会产生一组代表所要求的最后的牙齿布局的最后数字数据集,并储存起来。
对于专业治疗人员而言确定最后的牙齿布局的优选方法是确定最后牙齿的布局,例如,写出一个治疗方案。使用治疗方案来确定正牙程序所要求的结果在本技术领域是公知的。当形成了一个治疗方案或者其他最后的目标时,然后就能处理上述影象以符合这个方案。在有些情况下,有可能提供能够翻译这种治疗方案的软件来产生最后的影象,从而也就产生了代表最后牙齿布局的这一组数字数据集。
按照本发明的又一个方面,提供了用于产生许多组数字数据集的方法,这许多组数字数据集代表了一系列离散的牙齿布局从一个原始牙齿布局过度到最后牙齿布局。这种方法包括提供一组代表原始牙齿布局的数字数据集(可以按照以上所述的任何一种技术来完成)。还提供了一组代表最后牙齿布局的数字数据集。这最后一组数字数据集可以由上面描述的各种方法来确定。然后,在上述原始数字数据集和最后数字数据集的基础上产生出许多组逐次的数字数据集。一般,这些逐次的数字数据集是通过确定选定的各个牙齿在原始数据集与最后数据集之间的位置差,并内插上述位置差而产生的。这种内插可以在所要求那样多的许多离散阶段中完成,一般至少三个,常常是至少四个,更经常是至少10个,有时候至少25个,偶尔是40个或更多。这种内插对于某些,或者所有的位置差往往是线性内插。反之,这种内插也可以是非线性的。在一个优选实施例中,非线性内插是利用路径安排和碰撞检测技术,由计算机自动计算出来的,以避免各个牙齿之间的干涉。上述位置差与牙齿的移动相对应,此时,牙齿上任何一点上的最大线性移动是2mm或更小,通常是1mm或更小,常常是0.5mm或更小。
使用者常常要规定一些称为“关键帧”的目标中间牙齿布局,这些“关键帧”被直接包括在上述中间的数字数据集内。然后,本发明的方法按照上面所描述的方式,即,在这些关键帧之间用线性或非线性的内插确定这些“关键帧”之间的逐次数字数据集。这些关键帧可以由一个使用者来确定,例如由处理用于产生上述数字数据集的计算机上的可视影象的个人来确定,或者,也可以由专业治疗人员以与最后的牙齿布局的治疗方案同样的方式,作为一种治疗方案来提供。
按照本发明的又一个方面,提供了用于制造逐渐调节牙齿布局的器械的方法。上述方法包括:提供一组原始数字数据集,一组最后的数字数据集;以及产生许多代表如刚才所描述的,逐次的目标牙齿布局的,逐次的数字数据集。然后,根据代表这些逐次牙齿布局的至少一部分数字数据集,制造这些牙科器械。优选地,这种制造步骤包括控制一台根据逐次的数字数据集产生所要求的牙齿布局的逐次的正模型的制造机器。然后,利用常规的正向压力或者真空制造技术,制造出作为这种正模型的负模型的牙科器械。上述制造机器可以包括一台立体石版印刷机或者其他类似的机器,这种用于有选择地使一块未硬化的聚合物树脂硬化的机器,它根据上述数字数据集有选择地把树脂硬化成一种形状。其他可用于本发明的方法的制造机器包括机床和石蜡沉积机。
在本发明又一个方面中,本发明的用于制造牙科器械的方法包括为患者提供一组代表经过修正的牙齿布局的数字数据集。然后,用一台制造机器根据这组数字数据集制造出一个经过修正后的牙齿布局的正模型。然后,再根据这个正模型制成负模型的牙科器械。这种机器可以是上面提到的石版印刷机或其它机器,而正模型可以用现有的加压技术或真空模制技术来制造。
在本发明又一个方面中,按照本发明的制造牙科器械的方法包括:提供第一组代表一个患者的经过修正的牙齿布局的数字数据集。然后,从这第一组数字数据集产生第二组数字数据集,其中,这第二组数字数据集代表经过修正的牙齿布局的负模型。然后,根据第二组数字数据集控制上述制造机器,以产生上述牙科器械。这种制造机器一般依靠有选择地使未硬化的树脂硬化来制成这种器械。这种器械一般包括一个聚合物外壳,外壳上有形状能容纳牙齿的空腔,并且能弹性地使牙齿从原始牙齿布局重新定位到修正后的牙齿布局上。
下面,参照附图详细描述本发明的实施例。附图中:
图1A是一个患者的颚部,并且一般地指出了牙齿是如何用本发明的方法和装置来移动的;
图1B表示图1A中的一颗牙齿,并且指出了牙齿的移动距离是如何确定的;
图1C表示图1A中的颚部和一个逐渐调节位置的器械,该器械是按照本发明的方法设计的;
图2的框图表示本发明用于制造一组逐渐调节位置的器械的各步骤;
图3的框图给出了处理一组代表原始牙齿布局的原始数字数据集,以产生一组与所要求的最后牙齿布局相对应的最后数字数据集的步骤;
图4A是表示一种用于本方法的消除手段的流程图;
图4B表示被图4A中的程序消除了的空间的量;
图5是表示在处理图3中的数据集时,用于匹配高分辨率分量与低分辨率分量的程序的流程图;
图6A是表示用于完成牙尖检测算法的“检测”阶段的程序的流程图;
图6B是表示用于完成牙尖检测算法的“舍弃”阶段的程序的流程图;
图7表示用于产生多组中间数字数据集的方法,这些数字数据集用于制造本发明的调节器械;
图8A是表示由设计路径的算法所完成的各步骤的流程图;
图8B是按照本发明的一个实施例用于完成“可视性”功能的各步骤的流程图;
图8C是按照本发明的一个实施例用于完成“产品”功能的各步骤的流程图;
图8D是表示完成图8A中的设计路径的步骤128的各步骤的流程图;
图9A是表示用于完成在碰撞检测的过程中的循环碰撞测试的各步骤的流程图;
图9B是表示在按照本发明的一个实施例的碰撞检测的过程中完成的节点拆分过程的流程图;
图9C是表示向上述碰撞检测过程提供附加移动信息的各步骤的流程图;
图10表示按照本发明的方法,利用代表中间和最后的器械构造的许多数字数据集来制造多个器械的可替换的方法;
图11是在本发明的一个实施例中使用的一种数据处理系统的简化了的框图。
按照本发明,提供了利用许多离散的器械来逐渐移动牙齿的方法和装置,其中,每一个器械以相当小的移动量逐次移动患者的一颗或多颗牙齿。牙齿的移动方式是在正牙治疗中通常使用的方式,包括相对于垂直中心线的全部三个正交方向的平移,牙齿中心线在两个正牙方向(“根角”和“扭转”)的转动,以及绕着中心线的转动。
请看图1A,一个代表性的颚部100包括16颗牙齿102。本发明的目的是要把这些牙齿中的至少若干颗从原始牙齿布局移动到最后牙齿布局。为了说明牙齿是如何移动的,画出了一根通过牙齿102的任意的中心线(CL)。以这根中心线(CL)为基准,能在用轴线104、106和108(其中104是中心线)表示的三个正交方向上移动这些牙齿。上述中心线可以绕着轴线108(根角)和104(扭转)转动,分别如箭头110和112所指示。此外,牙齿还可以如箭头114所指示绕着中心线转动。因此,能完成牙齿的所有可能的自由形式的运动。现在请看图1B,用本发明的方法和装置所能达到的任何牙齿运动的幅度将以牙齿102上任何一点P的最大线性平移来确定。当牙齿以图1A中的任何一个正交或旋转方向移动时,每一点Pi的平移量都要累计起来。即,虽然一般情况下这一点将循着一条非线性路径移动,但在治疗过程的任何两个时间确定牙齿布局时,在牙齿的任何点之间都会有一个线性距离。因此,任意一点Pi可能在事实上作如箭头d1所示的真正的左右平移时,另一个任意的一点P2可能沿着一条弧线移动,其造成的最终平移为d2。本发明的许多情况要由在任何特定的牙齿上用本方法所引起的一点Pi的最大容许移动量来确定。这种最大牙齿移动量又由牙齿上点Pi的最大线性平移量来确定,该点Pi在该牙齿的任何一个治疗步骤中经受最大移动量。
请看图1C,按照本发明的系统包括许多逐渐调节位置的器械。这种器械能用以上所描述的方法逐渐使颚部上各个牙齿重新定位。广义的说,本发明的方法能使用任何公知的定位器、保持器,或者任何其他可移动的器械,这些器械都是普通的正牙治疗中为修正和保持牙齿布局所公知的。本发明的系统与现有技术中的设备和系统相反,它将提供许多要由患者逐次戴上的器械,以便达到以上所述的逐渐重新定位牙齿布局的目的。一种优选的器械100包括一个具有一空腔的聚合物外壳,该空腔的形状能容纳牙齿,并以弹性的方式使牙齿从一个牙齿布局重新定位到下一个牙齿布局上。通常,但不是必须,这种聚合物外壳能套在上下颚部的所有牙齿上。常常是只有一颗或几颗牙齿要重新定位,而其他的牙齿都是为在重新定位的器械对将要重新定位的牙齿施加弹性的重新定位力时,为它提供固定用的基础。但是,在情况复杂时,在治疗过程中有许多或者大多数牙齿要重新定位到某个点上。这时,被移动的牙齿也能够起固定重新定位的器械的基础的作用。此外,齿龈和/或底板也能够起固定部位的作用,因此,能让所有的或几乎所有的牙齿都同时重新定位。
图1C中的聚合物器械100通常是用一种合适的合成橡胶聚合物的薄板形成的,例如Tru-Tain的0.03英寸的热成形牙科材料,明尼苏达州55902,Rochster市的Tru-Tain塑料。一般为了在牙齿上固定这种器械,不需要钢丝或其他手段。但,在有些情况下,就需要或必须在牙齿上设置单独的紧固件,并且在器械100上要有相应的插孔,这样器械才能够对牙齿施加向上的力,但如果没有这种紧固件,就将无法施加。下面,描述制造这种器械100的具体方法。
请参阅图2,下面将描述本发明用于制造逐渐调节位置的器械的整个方法,患者用这种器械来使患者的牙齿重新定位。第一步,获得代表原始牙齿布局的一组数字数据集,以下称之为IDDS。这种IDDS可用各种不同的方式获得。例如,可以对患者的牙齿进行扫描,或者使用公知的技术进行造影,诸如X射线,立体X射线造影,计算机辅助的层析X射线摄影法,或者数据集、磁共振造影法等等。把这种普通的影象数字化以产生在本发明中使用的数据集的方法是公知的,公开在专利和医学文献中。但是,本发明常常依赖公知的技术来首先获得患者牙齿的石膏铸件,例如格拉勃(Graber)公开的“正牙学:原理与实践”,1969年,第二版,401-415页,费城,桑德斯。获得牙齿铸件之后,就能够用普通的激光扫描器或者其他测距装置进行数字扫描来产生IDDS。当然,由测距装置所产生的数据集可以转换成与用于处理该数据集范围内的影象的软件相兼容的其他格式,这一点还要在下面详细说明。一般用于制造牙齿的石膏铸件的技术,和利用激光扫描技术产生数字模型的技术,公开在诸如美国专利No.5,605,459中,该文献的全部内容都可作为本申请的参考。
测距装置有很多种类,通常根据测距过程是否需要与所测立体物体接触来分类。接触式测距装置利用一个具有多级平移和/或旋转自由度的测头。借助于记录测头在扫过样品表面时的实际位移,就能得到一个目标样品的计算机可读表示。非接触式测距装置或者是一种反射式的,或者是一种透射式的装置。正在使用的有各种各样的反射装置,其中的一些是利用非光学的入射能源,例如微波雷达或声纳。其他的则利用光能。那些靠反射的光能工作的非接触式装置还装有专门的仪器,这种仪器设计成能完成一定的测量技术(例如影象的无线电定位,三角测量和干涉测量)。
一种优选的测距装置是光学的、反射的非接触式扫描仪。非接触式扫描仪的优点在于其固有的无损性(即,不损坏样品目标),它的总的特征是拍摄物较高的分辨率和能在较短的时间内扫描一个样品。加州,蒙特里尔的Cyberware公司制造的Cyberware15型扫描仪是其中的一种。
无论是非接触式还是接触式扫描仪,都有一个有色摄象头,它在具有扫描功能的同时能以数字格式拍摄样品物体的彩色表示。这种不仅能拍摄样品物体的形状,还能拍摄出它的颜色,其重要性将在下面说明。
在一个优选实施例中,还要从患者得到一个蜡咬印。这种蜡咬印使得能在中央咬合位置上扫描上下牙齿的相对位置。其实现方法是,首先把下部铸件放在扫描器的前面,并使牙齿朝上,然后把蜡咬印放在下部铸件的顶上,最后,把上部铸件放在下部铸件的顶上,牙齿朝下,搁在蜡咬印上。然后对处在相对位置上的上、下铸件进行圆柱形扫描。扫描所得的数据形成一个代表物体的中间分辨率的数字模型,其是位于和嘴里的相对位置一样的位置上的患者的拱形的组合。
这种数字模型起引导上述两个单独的数字模型(每一个拱形一个)放置的样板作用。更精确的说,利用软件,例如Cyberware的对准软件,使每一个数字拱形逐次对准该成对扫描。然后,把单个模型定位在与患者嘴里的拱形对应的相对位置上。
本发明的方法是依靠在具有适当的图形用户界面(GUT)和适合于观看和修改影象的软件的计算机或工作站上处理上述IDDS。下面将详细描述这种软件的特定性能。虽然这种方法是依靠计算机来处理数字数据集,本发明的包括具有逐渐改变几何形状的多种牙科器械的装置可以用非计算机辅助技术来制造。例如,用上述方式获得的石膏铸件可以用刀子、锯或者其他切削工具切开,以便能让各个牙齿在该铸件中重新定位。然后,切开的牙齿可以用软蜡或其他可熔化的材料固定,这样,利用这种经过修正的患者牙齿的石膏铸件,能够设计出许多中间牙齿布局。不同的位置可以用于准备许多组器械,其一般是采用以下所描述的加压和真空模制技术。虽然一般都不太愿意采用这种手工制作的器械,但是,用这种方式制作出来的装置也包括在本发明的范围内。
请再看图2,在获得了IDDS之后,要把数字信息输入计算机或其他工作站进行处理。在这种优选的方法中,各个牙齿和其他元件将被“切开”,以便能使其单独重新定位,或者从数字数据集中去除。经过这样的元件“自由化”之后,使用者就要经常遵照专业治疗人员提供的治疗方案或其他书面说明。或者,使用者可以根据可视的外观或利用在计算机中编好程序的规则和算法对它们重新定位。一旦使用者对最后的位置满意了,这个最后的牙齿布局便组成一组最后的数字数据集(FDDS)。
根据IDDS和FDDS这两者,就能产生对应于一系列中间布局的许多中间数字数据集(INTDDS)。
图3表示一种用于处理上述IDDS以便在计算机上产生FDDS的有代表性的技术。一般从数字扫描仪输送来的数据是高分辨率的。为了减少计算机为产生影象所需要的时间,要形成一组平行的以低分辨率表示IDDS的数字数据集。使用者将处理这个低分辨率的影象,而计算机则将按照需要适时更新高分辨率数据集。如果在该模型中的附加的细节是有用的,使用者还可以观看/处理这个高分辨率的模型。上述IDDS还可以转换成四边数据结构,如果还没有用这种型式表现的话。四边数据结构是一种标准的拓朴数据结构,它是在1985年四月出版的ACM图解学报的第四卷第二期,74-123页中的“Primitives for theManipulation of General Subdivisions and the Computation of VoronoiDiagrams”提出来的。其他的拓朴数据结构,例如翼边缘数据结构也可以使用。
作为一个最初的步骤,当使用者看到患者的包括牙齿、齿龈和其他口部器官的颚部的立体影象时,他一般将把那些对于影象处理和/或最后制造器械来说不需要的结构删去。模型上这些不需要的部分可以用一种擦除工具将其消除,以完成一种实体建模减法。这种工具可由一种图形框来代表。要擦除的量(尺寸、位置和框的方位)由使用者用GUI设定。一般,不需要的部分包括外部的齿龈区域和原始扫描所得铸件的底部。这种工具的另一种应用是促进牙齿的拔掉,以及牙齿表面的“修整”。当为了要移动的牙齿的最后定位需要颚部中的额外空间时,这样做是必需的。治疗专业人员可以选择确定那些牙齿要修整和/或那些牙齿要拔掉。当只需要少量空间时,修整能让患者保持他们的牙齿。当然,一般说来,只有在按照本发明的方法开始重新定位之前,当实际患者的牙齿要拔掉和/或修整时,才在治疗方案中使用拔牙和修整。
去除模型上不需要和/或不必要的部分,加快了数据处理的速度,改善了显示效果。不必要的部分包括那些在制造牙齿重新定位器械时不需要的部分。去除这些不需要的部分减少了数字数据集的复杂性和大小,从而加速了数据集的处理和其他操作。
在使用者定位好擦除工具并规定了它的大小,并且指令软件把不需要的部分擦除之后,由使用者设定的框内的所有的三角形都要被除掉,而要对边缘上的三角形进行修正,以得到平滑的直线边界。上述软件删除了框内部所有的三角形,并且剪裁与框的边界交叉的所有三角形。这需要在框的边界上产生新的顶点。在模型上,在框表面上形成的孔要重新组成三角形,并利用新形成的顶点将其封闭。
上述锯切工具用于确定要移动的各个牙齿(或者也可能是成组牙齿)的轮廓。这种工具将扫描所得的影象分成单独的图形分量,使得软件能移动这颗牙齿或其他影象分量,而不影响模型上的其余部分。在一个实施例中,这种锯切工具确定了一条用两条放在空间的三次B样条曲线(有可能限制在平行的平面内,或者敞开的,或者封闭的)来切割图像的路径。一组线条把这两条曲线连接起来,并向使用者显示出总的切割路径。使用者可以编辑在三次B样条上的控制点,锯切厚度,以及所用的擦除器的数量。这些将在下面说明。
在另一个优选实施例中,用锯作为一种“核心”装置,从上方以垂直的锯切来分开牙齿。牙齿的齿冠,还有紧靠齿冠下方的齿龈组织从这种几何形状的其余部分分离开来,并作为称为牙齿的一个单独的单元来处理。当这个模型移动时,齿龈组织便相对于齿冠移动,形成在患者的口内改造齿龈的途径上的第一级近似值。
也可以把每一颗牙齿从原始修正后的模型上分离开来。此外,可以通过切掉牙齿的齿冠,从原始修正后的模型制造出一块底板。所得模型可以用作移动牙齿的底板。这样方便了从上述几何模型制造出最终实体模型来,这还要在下面说明。
厚度:当用一个切口把一颗牙齿分开时,使用者通常希望切口尽可能的薄。但是,使用者也许需要较厚的切口,例如,在下面说到的修整周围的牙齿时。在图像上,这个切口好象一条曲线,在曲线的一侧以切口的厚度为界。
擦除器的数量:一个切口包括许多一个挨一个排列的擦除器框,好象锯切工具曲线路径的分段线性近似。使用者选择擦除器的数量,这决定了所形成的曲线的完善程度,即,分段的数量越多,随着曲线的切割就越精确。擦除器的数量以图像的方式用连接上述两条三次B样条曲线的平行线的数量来表示。一旦锯切切口完全确定,使用者就可以在模型上加上这个切口。这个切口是以逐次的擦除来完成的。图4A中列出了一种常用的算法。图4B表示上述切口在用于开端B样条曲线的算法中描述的单个擦除累积法。对于一条垂直的切口来说,这两条曲线是用PA[O]和PA[S]相同的点来封闭的,而PB[O]和PB[S]是相同的点。
在一个实施例中,软件会自动根据使用者输入的平滑度的程度把锯切工具隔成一组擦除器。锯切还能够再细分,直到误差度量计测量出从理想的图像到近似的图像的偏差小于由设定的平滑度所规定的阈值。通常使用的误差度量计是把细分的曲线的线性长度与理想的样条曲线的弧长相比较。当差别大于从设定的平滑度计算出来的阈值时,便沿着这条样条曲线增加细分点。
还可以在上述软件上设置预显功能。这种预显功能以可视的方式以代表切口的相对两侧的两个表面显示出一条锯切的切口。这样,就能让使用者在对模型的数据集加上切口之前考虑最后的切口。
在使用者已经用上述锯切工具完成了全部需要做的切割工作之后,存在着许多图像实体。但是,此时软件还没有确定哪一些四角边缘数据结构的三角形是属于哪一些分量的。软件在数据结构中选择一个随机的开始点,并利用邻接的信息遍历这个数据结构,来找到所有互相连接的三角形,确定一个单独的成分。这个过程从分量还没有确定的三角形开始,反复进行。一旦遍历了整个数据结构,所有的分量也就确定了。
对于使用者来说,对高分辨率模型所作的改变似乎同时就在低分辨率的模型中发生了,反之亦然。但是,在不同分辨率的模型之间并不是一对一的关系。因此,计算机尽可能使高分辨率与低分辨率的成分“匹配”在它能够做到的限度内。这种算法示于图5。
齿尖的检测:在一个优选实施例中,软件具有检测牙齿齿尖的能力。齿尖是凸出在牙齿的咀嚼表面上的尖顶。齿尖的检测可以在切割阶段完成之前,也可以在完成之后。用于齿尖检测的算法包括两个阶段:(1)“检测”阶段,在该阶段中,确定牙齿上的一组点作为齿尖位置的候选点;(2)“剔除”阶段,在这个阶段中,从这一组候选点中剔除那些不满足齿尖所要求的一组标准的候选点。
图6A中列出了“检测”阶段所常用的算法。在这种检测阶段中,把可能的齿尖看作在牙齿表面上的一个“岛”,而候选的齿尖在这个岛上的最高点。“最高”是相对于模型的坐标系统来测量的,但是,如果检测是在治疗的切割阶段之后完成的,也可以比较容易地相对于每一颗牙齿的局部坐标系统来测量。
一组全部有可能的齿尖是通过在牙齿模型上寻找所有的局部最大值来确定的,这些最大值在模型的界限框顶部一个特定的距离之内。首先,将模型上的最高点指定为第一候选齿尖。一个平面通过这一点,垂直于测量出一点的高度的方向。然后将这个平面沿着Z轴线降低一个预定的很小的距离。接着,所有的与这颗牙齿连接的顶点,以及那些高于上述平面并且在一些连接起来的成分上的顶点,都和上述候选齿尖一起作为齿尖。这个步骤也称为“溢出填充”步骤。在每一个在这个步骤中访问过的模型的顶点做上记号,作为相应的候选齿尖的“一部分”,就能够根据每一个候选的齿尖点完成向外的“溢出”。完成了溢出填充步骤之后,校验模型上的每一个顶点。任何高于上述平面,并且还没有被上述一次溢出填充访问过的顶点都加在候选齿尖的表中。重复进行这些步骤,直到上述平面移动规定的距离。
虽然这种反复的寻找方法可能要比寻找局部最大值花费更多的时间,但是这种方法却能导致候选齿尖的表比较短。由于上述平面在每一个步骤中只降低有限的距离,所以由于噪声数据而可能发生的很小的局部最大值都被跳过去了。
在“检测”阶段之后,齿尖检测算法进行“剔除”阶段。“剔除”阶段常用的算法示于图6B中。在这个阶段,分析围绕着每一个齿尖候选点的局部几何形状,以确定它们是否拥有“不象齿尖的特征”。从齿尖候选点的表中去除那些表现出“不象齿尖的特征”的齿尖候选点。
可用作确定“不象齿尖的特征”的准则有很多。按照一种测试,围绕着齿尖候选点的表面的局部弧度可用来确定该候选点是否拥有不象齿尖的特征。如图6B所示,在大致确定了围绕着齿尖候选点的局部弧度之后,分析并确定它是否太大(非常尖的表面)或者太小(非常平坦的表面),在后一种情况下,就从齿尖候选点的表中去除这个候选点。对于这种最大和最小的弧度值要使用保守值,以保证不会因为差错而剔除真正的齿尖。
按照另一种测试,根据围绕着这个齿尖候选点的一个区域内的平均法向计算出平滑的量度。如果这个平均法向偏离该齿尖的法向而超出规定的量,就剔除这个候选齿尖。在一个优选实施例中,法向矢量N偏离齿尖法向CN的值用下式来估算:
1-Abs(N*CN)
当没有偏离时,这个值是零,当N垂直CN时,这个值是1。
一旦被分离开来之后,就能从IDDS形成FDDS。上述FDDS是按照正牙医生的把牙齿移动到最后位置的治疗方案形成的。在一个实施例中,把这种治疗方案输入计算机,计算机便按照算法计算牙齿的最后位置。在另一个实施例中,使用者可以在满足治疗方案的限制下独立地处理一个或几个牙齿,使这些牙齿移动到它们最后位置上。应该理解,以上所描述的技术的各种组合也可以用来达到最后的牙齿布局。
用于形成FDDS的优选方法在于使牙齿按照规定的逐次移动。首先,使每一颗牙齿的中心对准一个标准的拱形。然后,转动牙齿,一直到让牙根处于合适的垂直位置上。然后沿其垂直轴将牙齿旋转至合适的方向。然后,从侧面观察牙齿,并沿垂直方向将其平移到合适的垂直位置。最后,把两个拱形放在一起,并稍微移动牙齿,以保证上下拱形正确地啮合在一起。上下拱形的啮合可利用冲突检测算法来显示,用红色来突出牙齿的接触点。
在牙齿和其他成分已经安置好或去除掉之后,就能产生出最后的牙齿布局,如图7所示,这时必须制订一个治疗计划。如上所述,这个治疗计划将最终产生一系列INTDDS和FDDS。为了产生这些数据集,必须确定或规划出所选定的各个牙齿从原来的位置通过一系列逐次的步骤向最后的位置的移动。此外,为了在这个治疗方案中形成所要求的特点,还必须在这些数据集中增加其它特征。例如,为了形成用于特殊目的的空腔或凹槽,可能需要在图像上增加蜡制补丁。例如,可能需要在器械与牙齿或颚部的特定区域之间保持一个空间,以便减小齿龈的疼痛,避免周期性的问题,容许戴上罩子,等等。此外,可能常常需要提供一个用于容纳紧固件的插孔或小孔,这种紧固件是用于安放在一颗牙齿上,以便牙齿能用这个紧固件来处理,例如相对于颚部向上提高。
有些制造牙齿重新定位的器械的方法要求分开的重新定位的牙齿和其他部分统一在一个单一的连续的构件中,以便进行制造。在此情况下,可使用“蜡制补丁”来固定上述INTDDS的否则会断开的部分。这些补丁加在牙齿下方和齿龈上方的数据集上,于是它们就不会影响牙齿重新定位的器械的几何形状。应用软件为在模型上增加蜡制补丁提供了多样性,包括具有可调尺寸的框和球形。上述加上去的蜡制补丁由软件处理为与所有其他几何形状一样的几何形状附加成分。因此,这种蜡制补丁能在处理路径上和牙齿及其他成分一样重新定位。如上所述,这种优选的利用垂直核心分离牙齿的方法去除了对大多数“蜡制补丁”的需要。
在上述依靠产生正模型来制成重新定位的器械的制造过程中,在图像模型中加入蜡制补丁将产生一个具有同样的加入蜡制补丁的几何形状的正模具。因为这种模具是牙齿的正性,而上述器械则是牙齿的负性,当这种器械在上述模具上形成时,它将也能在加入这个模具的蜡制补丁的周围形成。当把器械放入患者的口内时,这种器械就会在该器械的内空腔表面与患者的牙齿或齿龈之间让出一个空间来。此外,这种蜡制补丁还可以用于在该器械内部形成一个与放入口内的紧固件配合的凹槽或孔,以便使牙齿向各方向移动,要不然就做不到这一点。
在这种蜡制补丁之外,单独的一个元件,通常是一颗牙齿,还可以按照比例放大或缩小尺寸,这样,所制成的器械就能相应地具有较紧或较松的配合。
治疗计划在确定牙齿和其他元件的移动方面是非常灵活的。使用者可以改变治疗阶段的数量,并且可以个别控制元件的路径和速度。
治疗阶段的数量:使用者可以改变牙齿从原始状态到目标状态所需要的治疗阶段的数量。任何不移动的元件都被认为是固定不动的,因此,假定它的最后位置和它的原始位置相同(对于所有的中间布局也同样,除非为那个元件确定了一个或多个关键帧)。
关键帧:使用者还可以通过选定一个中间状态和对元件的位置进行改变来规定“关键帧”。除非另有指令,软件将自动地在所有使用者规定的位置(包括原始位置,全部关键帧位置和目标位置)之间进行线性内插。例如,如果为一个特定的元件仅确定了一个最后的位置,那么在原始阶段之后的每一个后续的阶段将只显示该元件一个逐渐靠近最后位置的等量的线性距离和转动(由一个四元数规定)。如果使用者为该元件规定了两个关键帧,这个元件将从原始位置通过不同的阶段线性“移动”到由第一关键帧所确定的位置。然后,该元件有可能以不同的方向线性移动到由第二关键帧所确定的位置上。最后,该元件有可能以又一个不同的方向线性移动到目标位置。
使用者也可以在各关键帧之间规定非线性的内插。采用一条样条曲线以常规的方式来规定上述内插函数。
以上这些操作对于每一个元件可以独立地进行,所以,对于某一个元件的关键帧将不会影响另一个元件,除非这另一个元件也被使用者规定在那个关键帧中移动。一个元件可以沿着一条曲线在阶段3和阶段8之间加速移动,而另一个元件却从阶段1到阶段5作线性移动,并且之后突然改变方向,沿着一条线性路径缓慢地移动到阶段10。这种灵活性对于计划一个患者的治疗方案给予了很大的自由度。
在一个实施例中,软件自动地根据上述IDDS和FDDS确定治疗路径。这通常是利用一种确定各元件,即一颗牙齿,沿着一条直线的路径从原始位置移动到最后位置的速率的安排路径的算法来实现的。本发明所使用的这种安排路径的算法在确定处理路径的同时还避免了“兜圈子”,这是正牙医生对让牙齿沿着一条比矫正牙齿所绝对必须的距离更长的距离移动所用的术语。这种移动是非常不希望发生的,对患者有潜在的负面影响。为了避免“兜圈子”,上述安排路径的算法对所有牙齿的移动,通过限制它们在原始位置与最后位置之间的最短直线路径,按阶段排出逐次,同时还避免了各个牙齿之间的所有干涉。
这种安排路径的算法利用一种随机搜索技术,去找到一条通过一个构位空间的无障碍路径,这条路径描述了可能的治疗计划。下面描述用于安排两个使用者确定的总的关键帧之间的移动的算法的优选实施例。安排一段包括中间关键帧的时间段是这样来完成的:把时间段分成不包括中间关键帧的分时间段,独立地安排这些时间段,然后把所得到的这些安排串联起来。
图8A中的流程图120表示一种按照本发明的一个实施例的简化了的安排路径的算法。如图8A所示,第一步骤122涉及“构位空间”描述的结构。在本文中,“构位”指的是所有考虑要移动的牙齿的一组给定的位置。这些位置中的每一个位置可以通过许多途径来描述。在本发明的一个优选实施例中,位置是用一颗牙齿从其原始位置到最后位置的,规定位置上的改变的一个仿射变换和规定方向改变的一个旋转变换来描述的。每一颗牙齿的中间布局用一对数字来描述,这对数字规定在两个端点之间内插的位置和方向的位置。因此,对于每一个要移动的牙齿来说,一个“构位”由两个数字组成,而“构位空间”是指所有这种数字对的空间。因此,这种位空间是一种笛卡尔空间,其中的任何位置能够转换成对所有牙齿布局的规定。
描述每一颗牙齿从其开始位置到终端位置的运动的仿射变换可以分解成平移分量和旋转分量;这些变换是独立地用无矢量参数内插的,这些参数考虑了上述构位空间的二维。因此,整个构位空间由每一颗移动牙齿的二维所组成,所有这些在随后的搜索过程中都同等对待。
上述构位空间是由“自由空间”和“障碍空间”组成的。“自由”构位是那些代表真实的,实际上能实现的牙齿布局的构位,而“障碍”构位是那些不能实现的构位。要决定一个构位是自由的还是障碍的,要为牙齿的位置创作一个构位描述的模型。然后,应用一种冲突检测算法来确定是否有一种几何形状描述牙齿表面的相交。如果没有障碍,这个空间就被认为是自由的;否则就是障碍的。这种冲突检测算法下面还要更详细地讨论。
在步骤124中,确定了一种“可见度”函数V(s1,s2),这个函数在构位空间中取了两个矢量“s1”、“s2”作为输入并返回一个真或假的布尔值。只有在一条连接s1、s2的直线路径整个穿过构位空间的自由和无障碍区域时,上述可见度函数才返回一个真实值。可见度函数的一种优选的算法示于图8B。可见度函数可通过沿着s1、s2这条线在离散取样点上测试牙齿模型近似地计算出来。这样的技术,例如早期失效终止或通过递归细分要测试的区间来选择取样点的次序,可用于提高可见度函数的效率。
在图8A的步骤126中,确定了一种“产物”(children)函数C(s),它的输入参数“s”是构位空间中的一个矢量,并返回一组构位空间中的矢量“sc”。图8C表示计算产物函数C(s)所要遵循的步骤的简化了的流程图。在矢量组sc中的每一个矢量都满足V(s、sc)是真的特点,并且它的每一个分量都大于或等于相应的分量“s”。这意味着,任何由这样一个矢量所代表的状态都能从“s”达到,不会遇到任何干涉,并且不必完成任何不是在治疗方案规定的方向上的移动。每一个矢量组“sc”中的矢量都是通过用一些随机的,正向的量扰动“s”的各个分量而形成的。然后,计算出上述可见度函数V(s、sc),如果上述可见度函数返回到一个为真的布尔值,就把“s”加入到“sc”组中。此外,对于每一个如此产生的矢量都要把它的母矢量“s”的指针记录下来,以备后用。
在构位空间已经确定之后,在步骤128中,在原始状态“Sinit”与最后状态“Sfinal”之间完成路径的安排。图8D表示用于完成图8A中的步骤128的优选流程图。如图8D所示,在步骤128a中,确定了一组最初只包含了原始状态“Sinit”的状态“W”。接着,在步骤128b中,调用可见度函数来决定对于在W中对于至少一种状态si,V(S、Sfinal)是否是真。如果可见度函数返回到假布尔值,在步骤128c中,对于W中的所有Si,这一组状态“W”就用C(Si)的并集(union)来代替。重复步骤128b和128c,一直到V(S、Sfinal)对于任何属于W的Si均返回一个真布尔值。
在步骤128d中,对于V(S、Sfinal)为真的各Si,通过从父指针返回到Sinit建立了一条从Si到Sinit的无障碍路径Pi。在步骤128e中,从Sinit到Sfinal的路径是用从Si到Sfinal的最后的步骤把路径Pi串联在一起而建立起来的。如果从Sinit到Sfinal有多条路径,则在步骤128f中计算每一条路径的总长度。最后,在步骤128g中,选择长度最短的路径作为最后的路径。所选择的路径的长度与治疗计划所需要的总时间和阶段相对应。
得出的最后路径由一系列矢量所组成,每一个矢量代表该移动牙齿的变换的平移和转动分量的一组内插参数值。把这些值放在一起,就组成了一个避免牙齿与牙齿干涉的牙齿移动的次序表。
冲突检测算法:本发明所用的冲突或干涉检测算法是根据SIGGRAPH论文中所公开的算法得来的,斯蒂芬.高恰尔克(StefanGottschalk)等人,(1996):“OBBTree:A Hierarchical Structure forRapid Interference Detection”。上述SIGGRAPH论文的内容作为本申请的参考文献。
这种算法的中心点是围绕着被一个物体所占据的空间的循环细分,其是以类似于二叉树的方式组织起来的。三角形用来代表DDS中的牙齿。树的每一个节点被认为是一个定向的边界框(OBB),包含了在节点的母体中出现的三角形的子集。母节点的子节点中包含了它们之间所有储存在母节点中的三角形数据。
一个节点的边界框是这样来定向的,即,使得它紧紧地配合在上述节点中所有三角形的周围。树中的叶节点在理论上包含单独一个三角形,但是也可以包含一个以上的三角形。检测两个物体之间的冲突就是要决定这两个物体的OBB树是否相交。图9A示出描绘一种循环冲突测试的简化型式的流程图,以检查来自第一物体的“N1”是否与第二物体的节点“N2”相交。如果两颗树的根节点的OBB重叠,则对检查根的子节点是否重叠。上述算法以一种循环的方式进行,直到到达叶节点为止。此时,使用鲁棒性三角形交叉例程,来确定上述三角形在叶(端节点)处是否冲突。
本发明对SIGGRAPH论文中陈述的冲突检测的算法进行了一些改进。在一个实施例中,本发明提供了一种以缓慢的方式建立OBB树的独特方法,以节省存储器和时间。这种方法起源于观察到模型中有一部分是不会卷入冲突中的,因此不必计算模型的这些部分的OBB树。如图9B所示,当在确定循环冲突算法的过程中必要时,OBB树是借助于拆分树的内部节点来扩展的。
在本发明的另一个实施例中,在建立OBB树时,也可以专门从设计中排除模型中不需要冲突数据的三角形。如图9C所示,向冲突算法提供了附加的信息,以规定运动中的物体。运动可以从两个层面上来看。可以把物体看作全局的“运动”,或者,也可以看作相对于其他物体的“运动”。由于避免了互相静止的物体之间冲突信息的重复计算,上述附加的信息缩短了用于冲突检测的时间,因为这些物体之间的冲突状态并没有改变。
本发明的软件也可以合并,而使用者可以在任何点上利用一种“电影”的特点,以自动激活从原始状态到目标状态的运动。这有助于使整个治疗过程中的全体部分的运动都能够看见。
以上说明了用于成分鉴别的优选用户界面是一种三维的交互的GUI。三维的GUI对于部分的操作也是常用的。这样一种界面为专业治疗人员或使用者提供了带有数字模型成分的即时可见的交互作用。这对于那种只能让简单的,低层的命令来指示计算机操作一个特定区段的界面是更优选的。换句话说,适合于操作的GUI对于只能接受这样的指令,例如:“使这个元件向右平移0.1mm的界面是更优选的”。这种低层的命令对于微调是有用的,但,如果它们是唯一的界面,元件操作的处理过程将成为费力和耗时的交互作用。
在操作过程之前或当中,一个或者多个牙齿元件可以用牙根的样板模型来放大。操作用牙根模板放大的牙齿模型是有用的,例如,在需要关注在齿龈线以下的牙齿撞击的情况下。这些样板模型可以包括患者的牙齿的X射线的数字化的图像。
这种软件还能把注解加在数据集中,其包括文本和/或装置的逐次号。这种注解是作为凹入文本(即,它是三维的几何形状)加上去的,所以将出现在打印的正模型上。如果这种注解能够放在将被一个重新定位的器械盖住的口部的一部分上,但其对于牙齿移动不重要,那么这种注解就可能出现在交付的重新定位的器械上。
以上所描述的元件标识和元件的操作软件设计成以与操作者的训练程度相匹配的复杂程度工作。例如,操作元件的软件能通过提供有关牙齿的允许的和禁止操作的反馈来协助缺乏正牙训练的计算机操作者。另一方面,一个在口腔生理学和牙齿移位动力学方面技术非常熟练的正牙医生,就能够方便地用这种元件标识和操作软件作为工具,而不使用或者忽略提示。
一旦中间的和最后的数据集确立之后,就可以用图10所示的程序制造器械。通常,制造的方法要使用一种快速模型设计装置200,例如一种立体的平版印刷机。一种特别适用的快速模型设计机械是SLA-250/50型(加利福尼亚州,Valencia,3D装备公司)。这种快速模型设计机械200将有选择地把一种液体或者其他未硬化的树脂硬化成一个三维的构件,该构件能与其余未硬化的树脂分离开来,进行清洗,直接用作器械,或者间接地用作制造这种器械的模具。这种模型设计机械200将接收个别的数字数据集,并制造与每个需要的器械相对应的一个构件。一般,因为这种快速模型设计机械200可以利用具有非最佳机械性能的树脂,而这种树脂一般是不能用于患者的,所以最好是用这种模型设计机械来制作模具,而实际上这种模具是治疗过程中每一个后续阶段的正牙齿模型。准备好正模型之后,用一台普通的压力模制或真空模制机械,用更合适的材料,例如0.03英寸的热成形牙科材料(可从明尼苏达州55902,Rochester,Tru-Tain塑料公司购得)制成器械。合适的压力模制设备是一种商业名称为BIOSTAR的机器,它可从纽约的大湖牙科器材公司购得。上述模制机械250直接用正牙齿模型和所需要的材料制造各种器械。合适的真空模制机械可从RaintreeEssix公司购得。
制成之后,最好把包括本发明的装置在内的这许多器械一次都供应给治疗专业人员。这些器械可以用某种方式做上记号,通常是直接在器械上,或者在标签、口袋或者其他固定或包装在器械上的物件上标出器械的逐次号码,指明它们的使用次序。可选地,可以在装置上附上书面指示,说明患者应按照器械上或在包装的其他地方标明的次序戴上各个器械。按照这种方式使用器械将使患者的牙齿逐渐向着最后的牙齿布局进行重新定位。
图11是实施本发明的数据处理系统300的简化后的框图。数据处理系统300通常包括至少一个处理器302,该处理器通过总线子系统304与许多外设连通。这些外设通常包括:一个储存子系统306(存储器子系统308和文件储存子系统314);一组用户界面输入和输出装置318;以及一个通向外界网络(包括公用电话网络)的接口316。这个接口用“调制解调器和网络接口”方框316示意地表示,并且通过通信网络接口324与在其它数据处理系统中的相应的接口装置联结。数据处理系统300可以是一个终端,或者一台低档家用电脑或高档家用电脑,或者工作站或大型机。
用户界面输入装置通常包括一个键盘,还可以包括一个定点装置和一台扫描器。上述定点装置可以是一种间接的定点装置,例如一个鼠标,跟踪球,接触垫板,或图形输入板,或者一台直接定点装置,例如一块集成在显示器上的接触屏。其他类型的用户界面输入装置,例如语音识别装置,也可以使用。
用户界面输出装置一般包括一台打印机和一个显示子系统,该子系统包括显示控制器和连接在该控制器上的显示装置。这种显示装置可以是阴极射线管(CRT),诸如液晶显示器(LCD)之类的平板显示器,或者投影装置。上述显示子系统也可以提供非视觉显示,例如声音输出。
储存子系统306保持提供本发明的功能的基本程序和数据结构。以上讨论的软件模块通常储存在储存子系统306中。储存子系统306一般包括存储器子系统308和文件储存子系统314。
存储器子系统308一般包括许多存储器,这种存储器包括一个主随机存取存储器(RAM)310,用于在执行程序的过程中储存指令和数据,以及一个只读存储器(ROM)312,其中储存固定的指令。如果是Macintosh-兼容家用电脑,上述ROM应包括操作系统部分;如果是IBM-兼容的家用电脑,则应包括BIOS(基本输入/输出系统)。
文件储存子系统314为程序和数据文件提供永久的(非易失性)储存,而且一般包括至少一个硬盘驱动器和至少一个软盘驱动器(具有协同工作的可拆卸介质)。还可以有其他的装置,例如CD-ROM驱动器和光盘驱动器(都具有与其协同工作的可拆卸介质)。此外,这个系统还可以包括带有可拆卸介质的盒式磁带的驱动器。这种可拆卸介质的盒式磁带可以是硬盘盒式磁带,例如由Syquest公司出售的磁带,和软盘盒式磁带,例如由Iomega公司出售的磁带。可以把一个或多个这种驱动器放在远处,例如放在局域网的服务器中,或者放在Internet的WWW网站上。
在本文中,术语“总线子系统”一般用来包括让各种不同的元件和子系统互相联络的任何机构。除了输入装置和显示器之外,其他的元件不需要处在同样的实际位置上。因此,例如,文件储存系统的很多部分可以通过各种局域网或广域网介质,包括电话线来连接。同样,上述输入装置和显示器也不需要象处理器那样处在同样的位置上,尽管可预先考虑到本发明最经常是在PC和工作站的范围实施。
总线子系统304在图中用单个总线来示意地表示,但是,一个典型的系统应该有多个总线,例如局域总线和一个或多个扩展总线(例如,ADB、SCSI、ISA、EISA、MCA、NuBus、或者PCI),以及串行和平行端口。网络连接通常是通过一种装置建立起来的,例如在一个扩展总线上的网络适配器,或者在一个串行端口上的调制解调器。客户机可以是台式机或者便携机。
扫描器320负责对从患者或者从牙科医生那里获得的患者的牙齿的铸件进行扫描,并且把扫描所得的数字数据集信息提供给数据处理系统300进行进一步处理。在分布式环境中,扫描器320可以放在远处的位置上,并通过网络接口324把扫描得到的数字数据集信息输送给数据处理系统300。
制造机械322根据从数据处理系统300接收到的中间和最后数据集信息制造牙科器械。在分布式环境中,制造机械322可以放在远处的位置上,并通过网络接口324从数据处理系统300接收数据集信息。
以上是对本发明的优选实施例的完整的描述,但是,它的各种替换的、改进的或者等同的装置都可以应用。因此,以上的描述不应该用来限制本发明的范围,而应该由权利要求书来确定其范围。

Claims (10)

1.一种用于产生代表从原始布局逐渐过渡到所要求的中间或最后牙齿布局的一系列离散牙齿布局的多个数字数据集的方法,上述方法包括:
首先提供代表原始牙齿布局的数字数据集;
然后提供代表最后牙齿布局的数字数据集;
然后根据所提供的这些数字数据集产生多个逐次的数字数据集,其中,所述多个数字数据集代表逐渐从原始牙齿布局到最后牙齿布局的一系列逐次的牙齿布局。
2.如权利要求1所述的方法,其中所述提供代表原始牙齿布局的数字数据集的步骤包括对患者牙齿的三维模型进行扫描。
3.如权利要求1所述的方法,其中所述提供代表最后牙齿布局的数字数据集的步骤包括:
确定围绕着所述各个牙齿的至少一些牙齿的边界;以及
根据所述数字数据集使所述至少一些牙齿边界在一个影象中相对于其他牙齿移动,以产生最后的数据集。
4.如权利要求1所述的方法,其中所述产生多个逐次的数字数据集的步骤包括确定所述原始数据集与最后数据集的位置差别,并内插所述差别。
5.如权利要求4所述的方法,其中所述内插步骤是线性内插。
6.如权利要求4所述的方法,其中所述内插步骤是非线性内插。
7.如权利要求4所述的方法,还包括在所述原始牙齿布局与最后牙齿布局之间确定一个或多个关键帧,并在这些关键帧之间内插。
8.如权利要求1所述的方法,其中所述产生多个逐次的数字数据集的步骤包括产生代表在所述原始牙齿布局和最后牙齿布局之间的至少三个中间牙齿布局的至少三个数字数据集。
9.如权利要求1所述的方法,其中除了代表原始牙齿布局的数字数据集之外,每一个数字数据集代表所要求的中间或最后目标的牙齿布局。
10.一种用于产生代表从原始布局逐渐过渡到最后布局的一系列离散牙齿布局的多个数字数据集的方法,上述方法包括:
提供具有至少一个处理器和存储器的计算机系统;
向所述计算机系统提供代表原始牙齿布局的原始数字数据集;
向所述计算机系统提供代表最后牙齿布局的最后数字数据集;
根据所提供的原始和最后数字数据集产生多个逐次的数字数据集,所述多个数字数据集代表从原始牙齿布局渐进到最后牙齿布局的一系列逐次的牙齿布局,所述各逐次的牙齿布局适合在制造正牙器械时使用,以移动牙齿到牙齿布局。
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