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Publication numberCN102415916 A
Publication typeApplication
Application numberCN 201110217007
Publication date18 Apr 2012
Filing date29 Jul 2011
Priority date29 Jul 2011
Publication number201110217007.5, CN 102415916 A, CN 102415916A, CN 201110217007, CN-A-102415916, CN102415916 A, CN102415916A, CN201110217007, CN201110217007.5
Inventors厉松, 曾晓雁, 王振林, 田杰, 白玉兴, 郭宏铭
Applicant首都医科大学附属北京口腔医院
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
Correction method for preventing excessive stress concentration of teeth roots and jaws in process of orthodontic treatment
CN 102415916 A
Abstract
The invention relates to a correction method for preventing excessive stress concentration of teeth roots and jaws in the process of orthodontic treatment, belonging to the technical field of orthodontics of teeth. The correction method comprises the following steps of: establishing an automatic-matching 3D (three dimensional) integrated tooth-jaw model; carrying out stepwise virtual correction on the 3D integrated tooth-jaw model; applying 3D finite-element analysis to determine the dynamic change of stress distribution of the teeth roots and the jaws in the whole process of the virtual correction and guarantee that the stress of the teeth roots and the jaws in correction is in the safety range; and manufacturing a clinical correction device by a fast laser forming technology. By the individualized correction device designed and manufactured by a computer in an auxiliary manner, the positions and the routes of movement of the teeth roots can be controlled. By expression and verification, the correction method can duplicate the condition of virtual correction in actual treatment, realizes good position relation among the teeth roots, the teeth and the jaws in the correction process, and is beneficial to reducing and eliminating absorption of the teeth roots and the alveolar bones due to excessive stress concentration in the process of orthodontic treatment and reducing and avoiding recurrence after correction.
Claims(5)  translated from Chinese
1.防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法,其特征在于,具有以下步骤:(1)建立自动配准3D整合牙颂模型:(1. 1)取硅橡胶印取患者牙齿模型,并用石膏灌制,然后进行激光或结构光扫描,获得数字化的牙冠;(1.2)对患者面部拍摄锥束计算机断层扫描图片,用软件重建出颂骨及全牙列模型;(1. 3)用逆向工程软件把激光或者结构光扫描成的牙冠与锥束计算机断层扫描重建的颂骨以及全牙列模型自动配准后,切除重叠部分的牙冠,获得的3D整合牙颂模型包括激光或者结构光扫描的牙冠和锥束计算机断层扫描重建的牙根与颂骨;(2)在3D整合牙颂模型上进行分步虚拟矫治:(2. 1)在自动配准的3D整合牙颂模型上通过锥束计算机断层扫描和三维有限元分析确定牙根在颂骨内的安全移动范围,移动标准为:牙根的外表面离开皮质骨内表面0. 5mm 以上,其中牙根的根尖离开皮质骨内表面Imm以上;每个牙根的外表面均离开其它牙的牙根外表面0. 5mm以上,每个牙根的根尖均离开其他牙的牙根外表面Imm以上;牙根的外表面离开弹性模量大于1 X IO4MPa的高密度结构表面0. 5mm以上,牙根的根尖离开弹性模量大于1 X IO4MPa的高密度结构表面Imm以上;(2. 2)将三维牙颂整合模型上的每颗牙齿均分割成可以在三维方向移动牙齿,针对不同矫治器分别进行分步虚拟矫治;(3)三维有限元动态应力分析:(3. 1)将虚拟矫治过程中每一步整合牙颂模型上的牙根部分应用Mimics和Geomagic 软件建立牙根-牙周膜-牙槽骨模型,并利用三维有限元分析软件Ansys划分网格和加载载荷;(3.2)根据步骤(2.的分步虚拟矫治计划设定牙根移动的位置和路线,整个过程中保证牙根应力最大不超过lOMPa,颂骨应力最大不超过2MPa ;虚拟矫治结果以矫治计划和Andrews新六要素标准确定,同时满足无牙根不平行、无牙根外露;(4)通过激光快速成形技术制作临床矫治装置。 1. To prevent orthodontic treatment methods during treatment and maxilla Root excessive concentration of stress, characterized by the following steps: (1) the establishment of automatic registration 3D integration tooth Chung model: (1.1) take silicone rubber seal take Patients with dental models and plaster irrigation system, and then a laser or structured light scanning, access to digitized crown; (1.2) on the patient's face shot cone-beam computed tomography image, use software to reconstruct the mandible and the whole dentition model; (1 3) using reverse engineering software to the laser or structured light scanning into a crown and cone beam computed tomography reconstruction of the mandible and the whole dentition model automatically after registration, the overlapping part of the crown cut, obtained 3D integration tooth Song The model includes a laser or structured light scanning crown and cone beam computed tomography reconstruction of the root and the mandible; (2) the integration of the teeth on the 3D model step Chung virtual appliance: (2.1) in the automatic registration of 3D Integration teeth Chung model analysis to determine the root security within the range of movement of the mandible by computed tomography and three-dimensional finite element cone-beam mobile standards: the outer surface of the root of the left cortical bone surface 0. 5mm or more, including the root apical Imm away from the inner surface of the cortical bone above; outer surface of each root are away from the outer surface of the tooth root other than 0. 5mm, each root root root tips are leaving the outer surface of the tooth above Imm other; the outer surface of the root of the left elastic High-density structure of the surface modulus greater than 1 X IO4MPa of 0. 5mm or more, root apical left elastic modulus at 1 X IO4MPa high-density structure above the surface Imm; (2.2) the three-dimensional model of teeth on each song consolidation average teeth cut into the teeth can move in three dimensions, for different appliances were staged virtual appliance; (3) three-dimensional dynamic finite element stress analysis: (3.1) will further integrate teeth Chung model for each virtual treatment process The root part of the application Mimics and Geomagic software to build root - periodontal ligament - alveolar bone model, and using three-dimensional finite element analysis software Ansys meshing and loading loads; (3.2) according to the procedure step (2. virtual treatment plan set the root location and movement routes, the whole process to ensure a maximum root stress lOMPa, mandible stress a maximum 2MPa; virtual appliance results in treatment plans and Andrews six elements of the new criteria to determine, at the same time satisfy no roots are not parallel, without root exposure; (4) rapid prototyping technology to produce clinical treatment device by a laser.
2.根据权利要求1所述的防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法, 其特征在于,所述步骤(3.中,牙根应力进一步为最大不超过5MPa,颂骨应力进一步为最大不超过IMPa。 The treatment methods to prevent the course of orthodontic treatment and mandibular root stress excessive concentration of claim 1, wherein said step (3. the root stress further to a maximum 5MPa, mandible stresses further to a maximum IMPa.
3.根据权利要求1所述的防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法, 其特征在于,所述步骤(2.中,所述矫治器包括间接粘接托盘、个体化托槽和无托槽隐形矫治器。 3. The treatment methods to prevent the course of orthodontic treatment and mandibular root stress excessive concentration of claim 1, wherein said step (2., the appliance includes an indirect bonding tray, individual None of the brackets and bracket invisible appliance.
4.根据权利要求3所述的防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法, 其特征在于,所述使用间接粘接托盘和个体化托槽的虚拟矫治分为以下5步:排齐平整初期:患者初始治疗时,使用0. 014英寸钛镍弓丝,弓丝未平整;排齐平整后期:使用0. 022X0. 016英寸TMA弓丝,弓丝未平整;关闭间隙初期:使用0. 022X0. 016英寸不锈钢弓丝,弓丝完全平整,但没有移动牙齿关闭间隙;关闭间隙后期:使用0. 022X0. 016英寸不锈钢弓丝,移动牙齿关闭完成牙弓内所有间隙;治疗完成期。 4. The orthodontic treatment methods to prevent root during treatment and excessive concentration of stress maxilla according to claim 3, wherein said using indirect bonding trays and individual brackets virtual appliance into the following five steps : aligned initial formation: the initial treatment of patients, the use of 0.014 inches nickel titanium arch wires, the arch wire is not smooth; smooth aligned late: use 0. 022X0 016 英寸 TMA arch wire, the arch wire is not smooth; close the initial gap. : Use 0. 022X0 016 英寸 stainless steel arch wire, arch wire completely flat, but did not move to close the gap teeth; closed the gap late: 0. 022X0 016 英寸 use stainless steel arch wires, mobile dental arch closed the gap to complete all; treatment. completion date.
5.根据权利要求3所述的防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法, 其特征在于,所述使用无托槽隐形矫治器的虚拟矫治分为20-30步,每一步牙齿的移动量在0. 2mm以内。 5. The orthodontic treatment methods to prevent root during treatment and excessive concentration of stress maxilla according to claim 3, wherein the use of non-bracket invisible appliance virtual appliance into 20-30 steps, each step tooth movement amount is within 0. 2mm.
Description  translated from Chinese

防止正畸治疗过程中牙根和颌骨应力过度集中的矫治方法 Orthodontic treatment methods to prevent root during treatment and excessive concentration of the stress of the mandible

技术领域 Technical Field

[0001] 本发明属于牙齿正畸技术领域,特别涉及一种防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法。 [0001] The present invention belongs to the technical field of orthodontics, particularly to a method for correction during orthodontic treatment and mandibular root to prevent excessive concentration of stress.

背景技术 Background

[0002] 牙根吸收是正畸治疗的常见并发症之一,近年来的研究表明正畸治疗后牙根吸收甚至高达41. 6%,很多研究都表明正畸牙根吸收是伴随正畸治疗的常见现象,防止正畸治疗中牙根吸收是迫切需要解决的难题。 [0002] root resorption is a common complication of orthodontic treatment, recent studies have shown that even root resorption after orthodontic treatment up to 41.6%, a lot of studies have shown that orthodontic root resorption is a common phenomenon associated with orthodontic treatment prevent root resorption during orthodontic treatment is an urgent need to solve the problem. 正畸治疗牙根吸收的根本原因与牙齿移动过程中根尖应力过度集中有关,应力过度集中的原因,是牙根与颂骨在正畸治疗过程的位置关系不良造成的:例如前牙内收牙根靠近颂骨骨皮质会引起牙根吸收。 Orthodontic treatment of the underlying causes of root resorption and tooth movement apical stress related to excessive concentration, excessive concentration of stress reason is the root of the mandible in a poor positional relationship caused by orthodontic treatment: for example, close to Chung received within the first tooth root cortical bone can cause root resorption. 但是如何准确判断牙根在颂骨内的安全移动范围,以及如何精确控制牙根在颂骨内的安全移动,这些问题目前文献中尚未见报道。 But how to accurately determine the root security within the range of movement of the mandible, and how to precisely control the root security moves within the maxilla, these problems have not been reported in the literature.

[0003] 由于正畸牙根吸收是发生在三维方向上,传统的X片不能够准确观察。 [0003] Since the orthodontic root resorption occurs in three dimensions, conventional X-rays can not be accurately observed. 目前锥形束计算机断层扫描(cone beam computed tomography,CBCT)越来越广泛的应用于牙科,由于CBCT能够生成较高精度,与真实解剖机构1 : 1的三维图像,且放射剂量小,这对正畸牙根吸收的研究产生了巨大影响。 Currently cone beam computed tomography (cone beam computed tomography, CBCT) is widely used in dentistry, as CBCT can generate high precision, with the real anatomy mechanism 1: 1 in a three-dimensional image, and a small radiation dose, which is orthodontic root resorption had a tremendous impact. CBCT扫描虽然可以获得详尽的硬组织图像,但是分辨率最高的CBCT图像也只有0. Imm左右的精度,不能精确的显示牙齿的形状或精确的咬合关系, 因此不能用基于CBCT的数字化模型制作临床矫治器(间接粘接托盘,个体化托槽,无托槽隐形矫治器)。 CBCT scan although you can get a detailed image of hard tissue, but the highest resolution CBCT image is only about 0. Imm accuracy can not accurately display the exact shape of the teeth or occlusion, and therefore can not be based on the CBCT clinical digital model making Appliance (indirect bonding tray, individual brackets, no bracket invisible appliance). 它们的制作还必须依赖用激光或机构光扫描石膏模型建立的数字化牙冠模型,其精度可以达到0. 02mm甚至更高。 Their production also must rely on institutions with a laser or optical scanning digital crown model plaster model, and its accuracy can reach 0. 02mm or more. 要在虚拟矫治和数字化排牙中应用包括牙根和颂骨的牙颂模型,并输出临床矫治器,就必须将基于CBCT的数字化模型和基于激光或机构光扫描数字化牙冠模型进行整合。 To apply the virtual appliance and digitization row of teeth in the tooth root and Chung Chung model includes bone, and clinical appliance output, it must be based on digital models CBCT and laser or optical scanning digital crown agency model based integration.

[0004] 三维有限元分析是一种常用的应力分析方法,但是建模需应用放射剂量较大的CT,在放射剂量较低的CBCT没有广泛应用的情况下,目前尚不能在临床上对患者正畸治疗过程中牙根和颂骨进行动态的应力分析;另外一方面,目前虽然可以将牙根和颂骨纳入虚拟排牙,针对正畸治疗后牙根和颂骨位置关系进行控制,但是正畸牙根吸收是发生在正畸过程中,如何在整个正畸治疗过程中保证牙根和颂骨都没有应力过度集中,以往的技术尚不能完全解决。 [0004] The three-dimensional finite element analysis is a common method of stress analysis, modeling should be applied but larger radiation dose CT, at a lower radiation dose without a widely used CBCT case, it is not yet in clinical patients Orthodontic treatment during root and maxilla dynamic stress analysis; on the other hand, although currently may be involved in a virtual root and mandibular row of teeth, to control for root and mandibular positional relationship after orthodontic treatment, but the orthodontic root Absorption occurs in the orthodontic process, how to ensure that the entire process of orthodontic treatment and mandibular roots are not excessive concentration of stress, the conventional technology is not yet fully resolved.

发明内容 DISCLOSURE

[0005] 本发明针对上述问题,公开了一种防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法。 [0005] The present invention addresses the above problems, there is disclosed a method for preventing the correction of orthodontic treatment during root and maxilla excessive stress concentration.

[0006] 该方法具有以下步骤: [0006] The method has the following steps:

[0007] (1)建立自动配准3D整合牙颂模型: [0007] (1) the establishment of integrated automatic registration teeth Chung 3D model:

[0008] (1. 1)取硅橡胶印取患者牙齿模型,并用石膏灌制,然后进行激光或结构光扫描, 获得数字化的牙冠;[0009] (1.2)对患者面部拍摄锥束计算机断层扫描图片,用软件重建出颂骨及全牙模型; [0008] (1.1) take silicone rubber stamp patients taking dental models and plaster irrigation system, and then a laser or structured light scanning, access to digitized crown; [0009] (1.2) on the patient's face shot cone-beam computed tomography pictures, software reconstructed mandible and the whole tooth model;

[0010] (1. 3)用逆向工程软件把激光或者结构光扫描成的牙冠与锥束计算机断层扫描重建的颂骨以及全牙模型自动配准后,切除重叠部分的牙冠,获得的3D整合牙颂模型包括激光或者结构光扫描的牙冠和锥束计算机断层扫描重建的牙根与颂骨; [0010] (1.3) using reverse engineering software to the laser or structured light scanning into a crown and cone beam computed tomography reconstruction of the mandible and the whole tooth model automatically after registration, the overlapping part of the crown cut, obtained 3D integration tooth structure Chung model includes a laser or optical scanning of the crown and cone beam computed tomography reconstruction of the root and the mandible;

[0011] (在3D整合牙颂模型上进行分步虚拟矫治: [0011] ( Ode on a 3D model of the integration step tooth virtual appliance:

[0012] (2. 1)在自动配准的3D整合牙颂模型上通过锥束计算机断层扫描和三维有限元分析确定牙根在颂骨内的安全移动范围,移动标准为:牙根的外表面离开皮质骨内表面0. 5mm以上,其中牙根的根尖离开皮质骨内表面Imm以上;每个牙根的外表面均离开其它牙的牙根外表面0. 5mm以上,每个牙根的根尖均离开其他牙的牙根外表面Imm以上;牙根的外表面离开弹性模量大于1 X IO4MPa的高密度结构表面0. 5mm以上,牙根的根尖离开弹性模量大于1 X IO4MPa的高密度结构表面Imm以上; [0012] (2.1) on the integration of automatic registration of 3D cone beam dental Chung model by computed tomography and three-dimensional finite element analysis to determine the root security within the range of movement of the mandible, mobile standards: the outer surface of the root of the left 0. 5mm cortical bone surface, of which the root of the root tip from the inner surface of the cortical bone Imm above; the outer surface of each root are away from the outer surface of the tooth root other than 0. 5mm, each root apical all leave other The outer surface of the tooth root Imm above; leave the outer surface of the root of the elastic modulus of greater than 1 X IO4MPa high-density structure of the surface above 0. 5mm, root apical left elastic modulus greater than 1 X IO4MPa high-density structure above the surface Imm;

[0013] (2. 2)将三维牙颂整合模型上的每颗牙齿均分割成可以在三维方向移动牙齿,针对不同矫治器件分别进行分步虚拟矫治; [0013] (2.2) to each tooth tooth Chung integrated three-dimensional model can be moved on average cut into the teeth in three dimensions, for different treatment devices were staged virtual appliance;

[0014] (3)三维有限元动态应力分析: [0014] (3) three-dimensional dynamic finite element stress analysis:

[0015] (3. 1)将虚拟矫治过程中每一步整合牙颂模型上的牙根部分应用Mimics和Geomagic软件建立牙根_牙周膜_牙槽骨模型,并利用三维有限元分析软件Ansys划分网格和加载载荷; [0015] (3.1) will further consolidate virtual root part of the treatment process for each application and Geomagic software Mimics Chung model teeth on periodontal ligament establish roots _ _ alveolar model, and using three-dimensional finite element analysis software Ansys Meshing grid load and load;

[0016] (3. 2)根据步骤(2. 2)的分步虚拟矫治计划设定牙根移动的位置和路线,整个过程中保证牙根应力最大不超过lOMPa,颂骨应力最大不超过2MPa ;虚拟矫治结果以矫治计划和Andrews新六要素标准确定,同时满足无牙根不平行、无牙根外露,即无骨开裂和骨开窗的情况; [0016] (3.2) set the root to move locations and routes according to step (2.2) of the virtual treatment plan step by step, the whole process to ensure a maximum root stress lOMPa, mandible stress a maximum 2MPa; virtual treatment planning and treatment results in the six elements of the new criteria to determine Andrews, while meeting no roots are not parallel, no root exposure, that is, without cracking the case of bone and bone fenestration;

[0017] (4)通过激光快速成形技术制作临床矫治装置。 [0017] (4) rapid prototyping technology to produce clinical treatment device by a laser.

[0018] 所述步骤(3.中,牙根应力进一步为最大不超过5MPa,颂骨应力进一步为最大不超过IMPa。 [0018] The step (3. the root stress further to a maximum 5MPa, mandible stress further to a maximum IMPa.

[0019] 所述步骤(2. 2)中,所述矫治器件包括间接粘接托盘、个体化的唇、舌侧托槽、个体化的弓丝和无托槽隐形矫治器。 [0019] The step (2.2), the treatment device includes an indirect bonding tray, individualized lips, tongue side of the bracket, individualized arch wire and bracket invisible appliance no.

[0020] 所述使用间接粘接托盘和个体化托槽的虚拟矫治分为以下5步: [0020] The use of indirect bonding trays and individual brackets virtual appliance into the following five steps:

[0021] 排齐平整初期:患者初始治疗时,使用0. 014英寸钛镍弓丝,弓丝未平整; [0021] aligned flat early: patients initial treatment, the use of 0.014 inches nickel titanium arch wires, the arch wire is not smooth;

[0022] 排齐平整后期:使用0. 022X0. 016英寸TMA弓丝,弓丝未平整; [0022] aligned flat late: use 0. 022X0 016 英寸 TMA arch wire, the arch wire is not smooth;.

[0023] 关闭间隙初期:使用0.022X0. 016英寸不锈钢弓丝,弓丝完全平整,但没有移动牙齿关闭间隙; Early [0023] Close the gap: Use 0.022X0 016 英寸 stainless steel arch wire, arch wire completely flat, but there is no tooth movement to close the gap;.

[0024] 关闭间隙后期:使用0.022X0. 016英寸不锈钢弓丝,移动牙齿关闭完成牙弓内所有间隙; [0024] closed the gap late: Use 0.022X0 016 英寸 stainless steel arch wires, mobile dental arch closed the gap to complete all;.

[0025] 治疗完成期。 [0025] completion of the treatment period.

[0026] 所述使用无托槽隐形矫治器的虚拟矫治分为20-30步,每一步牙齿的移动量在0. 2mm以内。 [0026] The use of non-bracket invisible appliance virtual appliance into 20-30 steps, each step of the amount of movement of the teeth within 0. 2mm.

[0027] 本发明的有益效果为: [0027] The beneficial effects of the present invention is:

[0028] 通过虚拟矫治在治疗前就设定牙根在颂骨中移动的位置和路线,对整个实际正畸治疗过程进行模拟和控制,防止牙根和颂骨在正畸治疗中的应力过度集中,并通过先进技术将虚拟矫治转化为实际矫治,CAD/CAM的矫治装置(间接粘接托盘,个体化托槽,无托槽隐形矫治器)包含防止牙根和颂骨应力过度集中的信息,为防止正畸治疗中由于应力过度集中引起的牙根和牙槽骨吸收提供了解决方法,同时也可以避免正畸治疗后牙根不平行、 牙根外露(骨开裂和骨开窗)等副作用造成的牙周损伤和复发等风险。 [0028] The virtual appliance before treatment to set root in the mandible to move the location and route of the entire actual orthodontic treatment process simulation and control, to prevent root and maxilla in orthodontic treatment of excessive stress concentration, and Through advanced technology into practical appliance virtual appliance, CAD / CAM orthodontic devices (indirect bonding tray, individual brackets, no bracket invisible appliance) contains roots and prevent excessive concentration of stress maxilla information to prevent the positive Treatment of abnormal stress due to root and alveolar bone absorption caused excessive concentration provide a solution, but also to avoid the root is not parallel to orthodontic treatment, root exposure (cracked bone and bone window) and other side effects caused by periodontal damage and recurrence risk.

附图说明 Brief Description

[0029] 图1为本发明的流程图; [0029] FIG. 1 a flow chart of the present invention;

[0030] 图2为激光扫描获得的牙冠模型; [0030] Figure 2 is a tooth crown model obtained by laser scanning;

[0031] 图3 (a)和图3 (b)分别为CBCT重建获得的牙根和颂骨模型; [0031] FIG. 3 (a) and 3 (b), respectively root and mandibular model CBCT reconstruction obtained;

[0032] 图4为将激光扫描模型和CBCT模型整合后的3D牙颂模型; [0032] FIG. 4 is a laser scanning model and integration model after a 3D CBCT dental Chung model;

[0033] 图5 (a)和图5 (b)分别为牙根和颂骨动态应力分析 [0033] FIG. 5 (a) and 5 (b), respectively root and maxilla dynamic stress analysis

[0034] 图6为牙根在虚拟矫治各阶段应力分析示意图; [0034] FIG. 6 is a root virtual appliance in various stages of stress analysis schematic;

[0035] 图7为虚拟矫治最后一步的排牙模型;图7(a)为牙根平行度示意图;图7(b)为牙根与颂骨位置关系示意图。 [0035] FIG. 7 is the last step of the virtual appliance model row of teeth; Fig. 7 (a) is a schematic root parallelism; Figure 7 (b) of root showing the relationship between the mandible position.

具体实施方式 DETAILED DESCRIPTION

[0036] 本发明提供了一种防止正畸治疗过程中牙根和颂骨应力过度集中的矫治方法,下面结合附图和具体实施方式对本发明做进一步说明。 [0036] The present invention provides a method of preventing treatment during orthodontic treatment and mandibular root stress excessive concentration below in conjunction with the accompanying drawings and specific embodiments of the present invention is further described below.

[0037] 本发明所述方法的流程如图1所示: [0037] The process of the present invention is the method shown in Figure 1:

[0038] (1)制取数字化的牙列模型:用硅橡胶取患者印模,然后用高强度的石膏灌制模型,然后把牙合模型进行激光或机构光扫描获得数字化的牙合模型,如图2所示,其精确度较高。 [0038] (1) Preparation digital dentition model: with silicone rubber to take a patient die, and then plaster the irrigation system model of high intensity, then the occlusal model laser or agency optical scanning access to digitized occlusal models, such as as shown in FIG. 2, its high accuracy.

[0039] (2)重建颂骨以及牙根:拍摄患者颂面部CBCT,存为dicom格式文件,用Mimics软件根据牙齿与颂骨的密度不同而设置不同的阈值,选择合适的阈值将牙齿图像和颂骨图像分别分割三维重建,如图3(a)和图3(b)所示。 [0039] (2) reconstruction of the mandible and the root: shoot patient Chung facial CBCT, save for the dicom format files, and set different thresholds with Mimics software, depending on the teeth and mandible density, select an appropriate threshold teeth image and song bone reconstruction image segmentation respectively, as shown in 3 (a) and 3 (b) below.

[0040] (3)用逆向工程软件把激光或者结构光扫描成的牙冠与CBCT重建的牙冠自动配准后,将CBCT图像的牙冠部分切割掉,保留的CBCT牙根和颂骨的图像与扫描模型的牙冠图像合并,获得的3D整合牙颂模型包括激光或者结构光扫描的牙冠和CBCT重建的牙根与颂骨,如图4所示。 [0040] (3) reverse engineering software to the laser or structured light scanning into the crown after crown and CBCT reconstruction of automatic registration, the crown cut off part of CBCT images, retained roots and maxilla CBCT images and crown image merge scan model, 3D integration tooth Chung model obtained include crown and root CBCT reconstruction and mandible laser or structured light scanning, as shown in FIG.

[0041] (4)在自动配准的3D整合牙颂模型上通过锥束计算机断层扫描和三维有限元分析确定牙根在颂骨内的安全移动范围,移动标准为:牙根的外表面离开皮质骨内表面0. 5mm以上,其中牙根的根尖离开皮质骨内表面Imm以上;每个牙根的外表面均离开其它牙的牙根外表面0. 5mm以上,每个牙根的根尖均离开其他牙的牙根外表面Imm以上;牙根的外表面离开弹性模量大于1 X IO4MPa的高密度结构表面0. 5mm以上,牙根的根尖离开弹性模量大于1 X IO4MPa的高密度结构表面Imm以上。 [0041] (4) on the integration of automatic registration of 3D cone beam dental Chung model by computed tomography and three-dimensional finite element analysis to determine the root security within the range of movement of the mandible, mobile standards: the outer surface of the root of the left cortical bone the inner surface of 0. 5mm or more, including the root apical left cortical bone surface Imm above; outer surface of each root are leaving the outer surface of the tooth root other than 0. 5mm, each root apical are leaving other teeth Imm over the outer surface of the root; the outer surface of the root of the left elastic modulus of greater than 1 X IO4MPa high-density structure of the surface above 0. 5mm, root apical left elastic modulus greater than 1 X IO4MPa Imm high-density structure above the surface.

[0042] (5)在3D整合牙颂模型上针对间接粘接托盘、个体化托槽或无托槽隐形矫治器分别进行分步虚拟矫治:在三维牙颂整合模型上运用软件,将每颗牙齿分割成可以在三维方向移动牙齿,然后按照治疗计划进行分步虚拟矫治在动态虚拟矫治整个过程中保证牙根最大应力不超过IOMpa (实际应用中最好不超过为5Mpa);颂骨最大应力不超过2MPa(实际应用中最好不超过IMpa); [0042] (5) on a 3D model for the integration of dental Song indirect bonding tray, individual brackets or no brackets were invisible appliance virtual appliance step by step: the use of the software on three teeth Chung integration model, every single Teeth can move teeth is divided into three dimensions, and then follow the treatment plan step by step to ensure the virtual appliance in a dynamic virtual root treatment throughout the process does not exceed the maximum stress IOMpa (preferably no more than the practical application of 5Mpa); mandible maximum stress not over 2MPa (preferably no more than the practical application IMpa);

[0043] 对于间接粘接托盘和个体化托槽的虚拟矫治分为以下5步: [0043] For a virtual appliance indirect bonding trays and individual brackets are divided into the following five steps:

[0044] 排齐平整初期:患者未治疗时,使用0. 014英寸钛镍弓丝,弓丝未平整; [0044] Early aligned formation: untreated patients, the use of 0.014 inches nickel titanium arch wires, the arch wire is not smooth;

[0045] 排齐平整后期:使用0. 022X0. 016英寸TMA弓丝,弓丝未平整; [0045] aligned flat late: use 0. 022X0 016 英寸 TMA arch wire, the arch wire is not smooth;.

[0046] 关闭间隙初期:使用0.022X0. 016英寸不锈钢弓丝,弓丝完全平整,但没有移动牙齿关闭间隙; Early [0046] Close the gap: Use 0.022X0 016 英寸 stainless steel arch wire, arch wire completely flat, but there is no tooth movement to close the gap;.

[0047] 关闭间隙后期:使用0.022X0. 016英寸不锈钢弓丝,移动牙齿关闭完成牙弓内所有间隙; [0047] closed the gap late: Use 0.022X0 016 英寸 stainless steel arch wires, mobile dental arch closed the gap to complete all;.

[0048] 治疗完成期。 [0048] completion of the treatment period.

[0049] 对于无托槽隐形矫治器的虚拟矫治分为20-30步,每一步牙齿的移动量在0. 2mm 以内。 [0049] For non-bracket invisible appliance virtual appliance into 20-30 steps, each step of the amount of movement of the teeth within 0. 2mm.

[0050] (6)对牙根和颂骨进行动态应力分析:将虚拟矫治每一步整合牙颂模型上的牙根部分应用Mimics和Geomagic软件建立牙根-牙周膜-牙槽骨模型,并保存为三维有限元分析软件Ansys可以识别的格式,然后确定材料参数,划分网格和加载(10N*mm),如图5所 [0050] (6) of the root and the maxilla dynamic stress analysis: the virtual integration of each treatment step tooth root part of the application Mimics song on the model and Geomagic software to establish the root - periodontal ligament - alveolar bone model, and save it as a three-dimensional Ansys finite element analysis software can identify the format, and then determine the material parameters, meshing and load (10N * mm), as shown in Figure 5

7J\ ο 7J \ ο

[0051] (7)通过三维有限元分析设定牙根移动的位置和路线:应用三维有限元分析确定虚拟矫治整个过程中牙根和颂骨应力分布的动态变化,如果有应力过度集中的情况(牙根最大等效应力大于5Mpa,或者牙槽骨最大等效应力大于IMpa)则重新调整虚拟矫治牙根移动的位置和路线,保证牙根和颂骨应力在虚拟矫治各阶段都在安全范围内,如图6所示。 [0051] (7) by three-dimensional finite element analysis set locations and routes root movement: Three-dimensional finite element analysis to determine the virtual appliance dynamic changes throughout the process and maxilla root stress distribution, if there is an excessive concentration of the stress (root maximum stress is greater than 5Mpa, or alveolar maximum stress greater than IMpa) readjust the root virtual appliance moving locations and routes to ensure that the root and mandibular stress in various stages of virtual appliances are in a safe range, as shown in Figure 6 FIG.

[0052] 虚拟矫治最后结果:根据矫治计划和Andrews新六要素(包括颂骨)标准完成虚拟矫治最后一步排牙模型。 [0052] Virtual Appliance final result: according to treatment plan and Andrews new six elements (including mandible) standard virtual appliance final step to complete row of teeth models. 同时要求无牙根不平行,如图7(a),无牙根外露,如图7(b)。 No root while not parallel, as shown in 7 (a), no root exposed, as shown in 7 (b). 关于Andrews新六要素的内容请参见:张珂,白丁=Andrews 口颂面协调六要素在侧貌美学中的应用.国际口腔医学杂志,2010,37) :P236-239 ;Andrews LF : The six elements of orofacial harmony[J]. Andrews J Orthod Orofac Harmony,2000,1(1) :13_22。 About Andrews new six elements, refer to: Zhang Ke, commoner = Andrews opening song, coordinated and Application of Six Elements in the International Journal of Oral Science in the beautiful side, 2010,37): P236-239; Andrews LF:. The six elements of orofacial harmony [J] Andrews J Orthod Orofac Harmony, 2000,1 (1):. 13_22.

[0053] (8)通过激光快速成形技术制作临床矫治装置: [0053] (8) Rapid prototyping technology to produce clinical treatment device by laser:

[0054] 间接粘接托盘的制作:在虚拟矫治最后一步的模型上用三维绘图软件绘制全尺寸个体化舌侧或唇侧弓丝,用个体化弓丝定位虚拟舌侧或唇侧托槽,然后把含有定位好的托槽的整合模型的每个牙的坐标回到原来的错合状态,在错合模型上用软件生成虚拟间接粘接托盘,用激光快速成型技术输出实物转移托盘,转移托盘和个体化弓丝包含牙根移动位置和路线的信息。 [0054] The indirect bonding tray production: The final step on the virtual appliance model drawn with a full-size three-dimensional graphics software individualized lingual or labial arch wire, with individual positioning virtual lingual arch wire or labial brackets, Then the coordinates of each tooth comprising positioning groove integrated model of good care of back to the original state of malocclusion in the malocclusion model to generate the virtual indirect bonding tray with the software, using rapid prototyping technology transfers in kind output tray, transfer trays and individualized archwire contains the root position and the route information.

[0055] 个体化托槽的制作:在虚拟矫治最后一步的模型上生成个体化托槽底版和绘制全尺寸个体化舌侧或唇侧弓丝,用个体化弓丝定位绘制好的托槽体,然后用软件将托槽底板与托槽体合并完成个体化托槽计算机辅助设计。 [0055] The individual brackets make: generating individualized care bottom and draw a full-size version individualized lingual or labial arch wire in the final step of the virtual appliance model, good bracket body drawn with individual arch wire positioning , and then use the software to bracket plate bracket body and completion of the merger of individual brackets computer-aided design. 用选区激光熔化技术(selective laser metling,SLM)将虚拟的个体化托槽直接输出为实物托槽,个体化托槽和个体化弓丝包含牙根移动位置和路线的信息。 By selective laser melting technology (selective laser metling, SLM) to the individual virtual bracket directly to the physical output bracket, individual brackets and arch wires containing individualized root mobile location and route information.

[0056] 个体化弓丝的制作:根据CAD模型采用机械手或手工弯制个体化弓丝。 [0056] individualized archwire production: According to the CAD model using robotic or manual bending individualized arch wire.

[0057] 无托槽隐形矫治器的制作:按照治疗计划将虚拟矫治分为20-30步,进一步可以更细致的分为50步,保证每一步牙根和颂骨应力在安全范围,通过激光快速成形制作每一步的牙列模型(光固化模型),在光固化模型上真空压膜得到与虚拟矫治步骤相对应的无托槽隐形矫治器。 [0057] No bracket invisible appliance production: virtual appliance in accordance with the treatment plan is divided into 20-30 step further divided into 50 more detailed steps to ensure that every step of the root and the maxilla stress in the safe range, laser fast Each step of forming production dentition model (light-curing model), the light-cured film obtained virtual model of vacuum treatment step corresponds no bracket invisible appliance.

[0058] 临床应用效果:应用本发明所述方法制成的矫治器完成的临床病例,所有矫治牙齿发生牙根吸收(指治疗后原有牙根形态或者牙根长度改变)的比例在10%以内,所有发生牙根吸收的牙齿其吸收量在2mm以内;治疗后无牙根不平行(相邻牙齿牙根角度在15 以内),无牙根外露于颂骨。 [0058] The clinical effect: the proportion of clinical cases of the application of the present invention is a method of treatment made to complete all treatment dental root resorption occurs (referring to the original root form or after treatment root length change) is less than 10% of all tooth root resorption occurs within its uptake 2mm; no root non-parallel (adjacent tooth root angle at 15 or less), no root exposure in the maxilla after treatment.

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