DE19923978A1 - Process for computer-aided patient-specific presentation and planning of dental and / or prosthetic work - Google Patents

Abstract

The invention relates to a method for the computer-assisted patient-specific representation and planning of dental and/or dental prosthetic work and for processing and provision with dental prosthetic work pieces. According to the invention, a digitized image data base with a plurality of model tooth and jaw images is prepared. The stored data facilitate a two-dimensional or quasi three-dimensional representation on a computer monitor and the model images encompass objects, for example individual teeth, that are healthy or need dental treatment. The patient-specific data are collected and stored in a respective, access-protected file. The patient-specific actual state is visualized from the digitized data base using the respective data records of model images. A treatment data base that is available either online or offline is used to synthesize possible therapeutical measures. Once individual therapeutical measures are selected and interactively chosen for the specific patient, a therapy plan is automatically drawn up.

Description

The invention relates to a method for computer-aided patient-specific representation and planning of dental and / or denture work as well as preparation and later restoration with prosthetic workpieces according to Preamble of claim 1.

From the German patent DE 44 43 929 C1 a Ver drive to the patient-specific manufacture of and care known with prosthetic workpieces, where there first an impression of the initial situation of the Kie to be supplied he bite registration and preparation of a planning model high accuracy and then a Be Grinding teeth to be restored on the planning model becomes.

The prepared state of the planning model thus obtained is then z. B. by optical and / or mechanical scanning of predefined geometric configuration.

Then a preparation of the dental workpiece made. Grinding and Then prepare the teeth in the jaw to be restored based on the stored data of the prepared condition of the Planning model realized, this grinding by means of a numerically controlled in or on the oral cavity of the  Fixed milling and grinding device for patients. Immediately after this grinding, this can be done dental prosthetic workpiece inserted or cemented become.

With the teaching briefly described above, the treatment is successful overall time and the precision of the Manufacture of prosthetic workpieces to increase as well at the same time the costs in the laboratory and in the dental Lower practice. Time-consuming fittings can also correspond according to the usual intermediate steps in dental technology Production of the workpiece with appropriate, repeated Bite registration is eliminated and it's the probability of corrections or new versions of the dental prosthetic Workpiece itself low.

However, it has been shown that for more extensive care of a patient in the run-up to the actual treatment More care must be taken. This is also possible to optimize treatment success and treatment str to create strategies that are both cost-effective as well visually optimized for individual circumstances.

Furthermore, it can be assumed that treatment times will be shortened and therefore costs can be reduced if the patient already fully informed and involved in the preliminary phase is, so that there is a correspondingly positive basic attitude also leads to possibly critical interventions.

From the above, it is therefore an object of the invention to Process for computer-aided patient-specific Dar provision and planning of dental and / or dental prosthetics Work as well as for preparation and later care To specify prosthetic workpieces with the help of which it succeeds, on the one hand, time-specific patient-specific actual situations to capture and present them appropriately, so that from a multitude of resulting ones Treatment options considering health  risks and optimized when considering the cost aspects Therapy measures can be derived and these convincing can be presented to the patient, but also to the patient treating doctor to facilitate the decision.

On the other hand, there should also be the possibility of further improve treatment planning online to external To use information or data so that the otherwise necessary updating minimized.

The object of the invention is achieved with a Ver drive as defined in claim 1, wherein the Subclaims at least useful configurations and Training includes.

The basic idea of the invention is first of all a digitized image database, which a Variety of model tooth and jaw views included.

This image database contains both shots of healthy ones also teeth with various pathological changes or states. The stored data of the tooth and jaw views enable a two-dimensional or quasi-three-dimensional one Representation on a common computer monitor. It is in the Purpose of the invention that both complete rows of teeth as well Individual teeth are stored digitized, then in subsequent process steps a synthetic jaw or denture representation depending on the actual situation to be able to work out.

The image database can not only be two-dimensional, pixeloria contain descriptions, but also data have sets derived from three-dimensional models and in addition to pixel and vector orientation have.

After creating the digitized image database or back then such an existing database is accessed an acquisition of patient-specific data is carried out and this data is stored in a respective one access-protected file. There is also the possibility  take photographs of the patient on site, especially images of the mouth and jaw region, and this Also save recordings in digitized form, this storage preferably in the corresponding patient-specific file.

Using the digitized data from the image database with the model tooth and jaw views and after recording the patient-specific data is then generated using the computer and the associated monitor a visualization of the actual-to status of the respective patient according to the given Findings made.

This patient-specific as-is condition can be helped a common output medium, e.g. B. a printer and documented or given to the patient become.

After the visualization of the patient-specific findings-is-to have been made, a synthesis of possible therapy steps using an online or treatment database available offline. This Treatment database includes at least information regarding materials to be used in the treatment of the expected tendency in time and the estimated costs as well of a possible patient-specific treatment risk the anamnesis entered. Regarding online or offline radio this is not to be understood as restrictive, because in principle every database information is central or decentralized can be held or managed. In one embodiment z. B. the possibility that the specific patient is not more data side in the actual dental practice, but on a server to a health insurance company or another Institute is managed. There is also the possibility that depending on the patient and therapy planning, the list of services the appropriate health insurance company, the changes may be subject to use via online access.  

After interactively synthesizing the treatment steps with the help of the database, an auto takes place matically derived a now optimized therapy plan. The Optimization process is the result of a Selection of individual therapy steps and regarding the patient interactive selection of these steps. The therapy plan in another patient-specific, protected file for later therapy control and Billing and documentation purposes saved.

After the therapy plan is created and confirmed in principle is a process visualization of the patient specific conditions during and / or after treatment steps presented based on the therapy plan, whereby here again on the image database of the model views of Zahn and Jaws for decision making for patient and practitioner is used.

By means of the method according to the invention can be in relative short time, d. H. during a single consultation, both the Treatment strategy easy after an optimized assessment create as well as convincingly the consent of the Reach patients if necessary after presenting alternatives.

Because it is possible to capture patients specific data an imaging of at least the oral and maxillary and / or face region of the respective patient, can both the visualization of the actual state as well the expected condition for treatment planning, d. H. improve in terms of treatment success.

In a preferred embodiment of the invention, after Visualization and recording of the current state via a before online connection enables a data exchange with a dental technician African laboratory made especially for prosthetic Work to capture planning alternatives and / or planning to provide help or access.  

For the visualization of the patient-specific current status preferably includes the image database images of typical, age-classified male and female mouth regions, so that even without an individual imaging a convincing Presentation that is accepted by the patient can be achieved can.

So that the acquisition of patient-specific data reprodu is achievable and can be achieved with little effort used a macro database for anamnesis analysis. With This database then makes it possible to set up an automatic risi co-evaluation regarding later treatment planning or individual treatment steps, whereby look-up-Ta barks stored in the computer can be used are.

The fact that according to the invention there is the possibility of both the digitized image database as well as the macro database to be ordered externally for anamnesis analysis and online it is possible to access the hardware as well as the software less effort at the dentist or in the laboratory.

In addition, there is the possibility of individual complexes or particularly critical findings on external knowledge databases access and / or decision on the computer monitor offering trees for optimized treatment planning and to represent.

For planning tooth and / or jaw correction measures can be elements or parts of the visualized patient spec actual state, d. H. according to the image content, moved or removed under cursor control.

The therapies that can be planned include conservative, surgical, prosthetic, functional, implantological, prophylactic and other measures.

From the possible linkage of various optimized Treatment strategies can be used for the treating doctor  Derive daily schedule optimization and thus both the loading control system as well as the time management much more effectively four. There are no special ones for the application of the method Software or computer skills required as the individual Processes or steps are menu-supported and in dialogue are unwindable. Furthermore, after recording the findings and Dentist-typical entry of less data from the digitized Image database with the model tooth and jaw views automatically the actual load to be visualized without further intervention Fund presentation derived.

Furthermore, in a supplementary embodiment, the inventor provided for both the visualization of the patient spec fish actual state as well as for later documentation the success of treatment after therapy intraoral images with an appropriate camera and the image data to file.

Primarily, however, it should not be necessary for the patient to be treated Patients take pictures to the current state mentioned to be able to visualize. Rather, it will appear on the surface the aforementioned digitized image database was used.

To facilitate the selection of therapy steps when used the presentation of the current status is possible sensitivity, deterioration that can occur without prevention or Treatment result through an appropriate animation in order to make possible temporal processes clear and to be able to evaluate certain treatment methods at the same time.

Overall, the procedure described offers the dentist or Dental technician on the display of a computer system a virtual patient, with the help of this adjustable diagnosis-actual state an optimized treatment strategy can be worked out and at the same time targeted treatment results and treatment successes to the patient in advance are presentable. It also allows the one made in this way Optimization and therapy planning, the costs at the dentist  and / or lower in the laboratory and time management both regarding the required sessions as well as the day to improve the doctor's planning.

Regarding the macro database for medical history analysis the system to be self-learning, d. H. it can be experience Values and insights are also entered by auto Statistical evaluation of repeated information or Queries risks uncovered and closer science be examined. For this there is Possibility of subset of patient-specific data withdrawn patient-neutral and as mentioned a statistical To undergo evaluation.

Claims (8)

1. Procedure for computer-aided patient-specific presentation and planning of dental and / or dental prosthetic work as well as for the preparation and subsequent supply of dental prosthetic workpieces characterized by the following steps:

• - Creation of a digitized image database with a large number of model tooth and jaw views, the stored data of the tooth and jaw views enabling a two-dimensional or quasi-three-dimensional representation on a monitor and the model views showing healthy and dental objects, e.g. B. include single teeth;
• - Acquisition of patient-specific data and storage of this patient-specific data in an access-protected file;
• - Visualization of the patient-specific status as-is using the corresponding data sets of model views from the digitized image database;
• - Synthesis of possible therapy steps using an online or offline treatment database with information regarding at least the materials to be used, the expected time required for treatment and the estimated costs as well as a patient-specific treatment risk;
• - Automatic derivation of a therapy plan after selection of individual therapy steps and interactive selection of these steps with respect to the patient;
• - Filing this therapy plan in another patient-specific protected file for later therapy control and for billing and documentation purposes; and
• - Predictive visualization of the patient-specific condition during and / or after the treatment steps based on the therapy plan using the image database of the model views of tooth and jaw for decision-making for patient and practitioner.

2. The method according to claim 1, characterized in that imaging when collecting patient-specific data at least the mouth, jaw or face region of the respective Patient and that the image or images received in the Patient file for later visualization of the current status and / or the states for the treatment planning become. 3. The method according to claim 1 or 2, characterized in that after visualization and recording of the actual state via a prefers online connection to data exchange with a dental laboratory done to planning alternatives too record and provide planning aids and / or access. 4. The method according to any one of the preceding claims, characterized in that to visualize the patient-specific actual state Image database Images of typical, age-classified male and female mouth regions. 5. The method according to any one of the preceding claims, characterized in that for capturing patient-specific data on a Macro database for medical history analysis is used, whereby an automatic risk assessment with this database later treatment planning including the Creation of exclusion criteria using lookup Tables is carried out. 6. The method according to any one of the preceding claims, characterized in that for the teeth to be treated and / or the one to be treated Kiefer about and with the computer monitor decision trees for offered and presented optimized treatment planning become.   7. The method according to any one of the preceding claims, characterized in that for the planning of tooth and / or jaw correction measures Elements or parts of the visualized patient-specific Actual state of the image content on the cursor-controlled movement or are removable. 8. The method according to any one of the preceding claims, characterized in that the decentralized or centralized digitized image database is organized and accessed online.