WO2007134701A1 - Method for creating a personalized digital planning file for simulation of dental implant placement - Google Patents

Method for creating a personalized digital planning file for simulation of dental implant placement Download PDF

Info

Publication number
WO2007134701A1
WO2007134701A1 PCT/EP2007/003810 EP2007003810W WO2007134701A1 WO 2007134701 A1 WO2007134701 A1 WO 2007134701A1 EP 2007003810 W EP2007003810 W EP 2007003810W WO 2007134701 A1 WO2007134701 A1 WO 2007134701A1
Authority
WO
WIPO (PCT)
Prior art keywords
dental
ray image
soft tissue
dental implant
receptor sites
Prior art date
Application number
PCT/EP2007/003810
Other languages
French (fr)
Inventor
Carl Van Lierde
Bert Van Roie
Original Assignee
Materialise Dental N.V.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Materialise Dental N.V. filed Critical Materialise Dental N.V.
Priority to JP2009510313A priority Critical patent/JP5561764B2/en
Priority to US12/301,293 priority patent/US9579170B2/en
Priority to EP07724737.7A priority patent/EP2029047B1/en
Publication of WO2007134701A1 publication Critical patent/WO2007134701A1/en

Links

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
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
    • 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
    • A61C9/0053—Optical means or methods, e.g. scanning the teeth by a laser or light beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/04—Measuring instruments specially adapted for dentistry
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture

Definitions

  • the present invention relates to simulation of dental implant placement and more particularly relates to a method for creating a personalized digital planning file for simulation of dental implant placement as well as software for carrying out any of these methods and to computer systems implementing these methods.
  • Surgical planning for dental implant placement traditionally uses medical imaging modalities to verify the quantity and quality of a jawbone.
  • Multi-planar reformatted CT computed tomography
  • CT offers means to visualise the oral anatomy of a patient in a number of differently oriented slices of a volumetric scan and to graphically superimpose on the images representations of commercial implants of varying length, diameter and brand (for example, SimPlantTM provided by Materialise, Leuven, Belgium).
  • a patient is sent to a radiologist for a CT scan.
  • the result of the scan is a stack of 2D slices forming a three- dimensional volumetric "data set" which can then be used as input for a dental planning program.
  • a program imports the data set provided by a radiology site without altering any information.
  • image-processing techniques such as, for example, image segmentation
  • three-dimensional models of the bone may be derived from the data set.
  • the practitioner subsequently defines a curve that follows the arch of the jaw. Several cross-sections can be chosen perpendicular to both the panoramic curve and the axial slices. Typically, implant receptor sites may be chosen in these cross- sections.
  • the practitioner can modify the positions and inclinations of each implant as needed in any of the views, including the 3D view. Fine tuning is performed by shifting and tilting of the implant representations or by changing their dimensions. Each individual implant position can be evaluated in terms of the volume of available bone and its quality. The latter is interpretable in CT images by means of the number of Hounsfield units attributed to each of the voxels, i.e. volumetric building blocks of the CT images. Disadvantages of using CT for dental implant planning are the additional costs related to scanning and the fact that significant irradiation of the patient is required in order to obtain the volumetric data. Moreover CT or CT-like scanning equipment, such as e.g. cone-beam scanners, is costly and has yet to be widely used in the dental market. Scanning equipment is therefore not always readily available.
  • US 6,319,006 describes a method for producing a drill assistance device for a tooth implant in which an X-ray image is correlated with a three- dimensional image of optically measured visible parts of a patient's remaining dentition.
  • the method comprises taking an X-ray picture of the jaw and the compilation of corresponding measured data record, a three-dimensional, optical measurement of the visible surfaces of the jaw and of the teeth and the compilation of a corresponding measured data record.
  • the measured data records from the X-ray picture and the measured data records from the three- dimensional, optical image are correlated with each other. Based on the information that is available, the type and position of the implant relative to the adjacent teeth is planned and a drill template is produced which is attached to the neighbouring teeth, thus making the exact drilling of an implant pilot hole possible.
  • a disadvantage of this way of working is the lack of three- dimensional information about the shape of the jawbone. While the X-ray image provides information about the bone in a projected image, it does not provide insights about the level of the bone in cross section along the dental arch. As an example, Fig. 1 shows two exemplary cross-sections of a jawbone, which on a frontal X-ray image would both be visualized identically. However the bone in both sections is very different as can be seen from Fig. 1. In WO 2004/064660 a method for dental registration is provided.
  • the method comprises rigidly coupling a base element to a maxillofacial area, inserting an object comprising at least one of a tool and a tool guide into a mouth in the maxillofacial area, and determining a position of the object relative to the rigid element without a reference element outside the mouth.
  • the method may comprise combining two non- volumetric images of at least part of the maxillofacial area.
  • the non-volumetric images can be obtained by X-ray, optical scan data or direct bone surface measurements.
  • the method may comprise acquiring the first non-volumetric image including at least a part of the base element, identifying at least one registration mark of the rigid element and registering the image to the second non-volumetric image, thereby registering the registration mark to the area.
  • a method for creating a personalized digital planning environment for simulation of dental implant placement from (i) a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, (ii) an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, and (iii) a two-dimensional dental X-ray image of the potential dental implant receptor sites, the method comprising:
  • - generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three-dimensional surface model of the bone at the potential dental implant receptor sites.
  • An advantage of the present invention is that it does not require costly CT equipment and measurements, while still providing information about the bone structure.
  • the method according to embodiments of the present invention does not require the use of volumetric imaging techniques such as e.g. CT
  • CT scans submit the patient to a significant radiation loading, avoiding them is advantageous for the patient.
  • Patient specific information which may possibly be obtained from different sources such as e.g. optical scanning, digital photography, non-volumetric X-ray etc., may be combined in a digital manner for obtaining a single digital project that can be used by e.g. a clinician in maxillofacial planning software for the purpose of simulating a surgical intervention such as dental implant placement.
  • the digitized representation of an intra-oral surface anatomy may be investigated for possible dental implant receptor sites.
  • the digitized representation of an intra-oral surface anatomy may be for the entire dental arch of the upper jaw and/or lower jaw.
  • the digitized representation of an intra-oral surface anatomy may be a surface scan, e.g. an optical scan, e.g. optical surface scan, of the mouth of the patient.
  • the digitized representation of an intra-oral surface anatomy may be obtained from an impression of the upper jaw and/or lower jaw, whereby this impression may be used to digitally capture spatial coordinates of the intra-oral surface.
  • the digital representation of the soft tissue may be obtained via statistical information from an expert system.
  • the soft tissue may have a thickness and the digital representation of the soft tissue thickness may be obtained via local measurements of the thickness of the soft tissue.
  • the local measurements of the thickness of the soft tissue may be obtained by using a depth gauge, such as, for example at least one hypodermic needle.
  • the local measurements of the thickness of the soft tissue may, for example, be obtained from ultrasound measurements.
  • mapping the dental X-ray image along at least part of the dental arch may be performed by folding the dental X-ray image along the curved surface.
  • Mapping the dental X-ray image along at least part of the dental arch may comprise indicating corresponding points on the dental X-ray image and on the intra-oral surface anatomy.
  • Mapping the dental X-ray image along at least part of the dental arch may comprise non-uniform stretching of the X-ray image.
  • mapping the dental X-ray image along at least part of the dental arch may include linear scaling of the X- ray image in the apical-coronal-direction or Y-direction of the patient.
  • mapping the dental X-ray image along at least part of the dental arch may include non-linear scaling of the X-ray image in the horizontal direction or X-direction.
  • Constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may be performed by offsetting the soft tissue thickness inwardly in a direction towards the jawbone.
  • Generating a single digital project file comprising information obtained in the previous steps may be performed by combining obtained digital information in a single digital project visualisable on a display screen.
  • the method may furthermore comprise importing the digital project file into implant planning software.
  • a computer program product for executing any of the methods according to the present invention when executed on a computing device associated with a simulation device for simulation of dental implant placement.
  • the present invention also provides a machine readable data storage device storing the computer program product according to the present invention.
  • the present invention provides transmission of the computer program product according to the present invention over a local or wide area telecommunications network.
  • the present invention furthermore provides a computer system for creating a personalized digital planning environment for simulation of dental implant placement from (i) a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, (ii) an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, and (iii) a two-dimensional dental X-ray image of the potential dental implant receptor sites, the system comprising: - means for mapping the two-dimensional dental X-ray image of the potential dental implant receptor sites along at least part of a dental arch of the digitised intra-oral surface anatomy,
  • - means for generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three-dimensional surface model of the bone at the potential dental implant receptor sites.
  • the means for mapping the two-dimensional dental X-ray image may comprise means for investigating for possible dental implant receptor sites.
  • the means for mapping the two-dimensional dental X-ray image may comprises mean for performing a surface scan of the mouth of a patient.
  • the means for mapping the two-dimensional dental X-ray image may comprise means for performing linear scaling of the X-ray image in the apical- coronal direction of the patient.
  • the means for mapping the two-dimensional dental X-ray image may comprise means for performing non-linear scaling of the X-ray image in the horizontal direction.
  • the soft tissue may have a thickness and the means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may comprise means for local measurement of the thickness of the soft tissue.
  • the means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may comprise means for performing offsetting the soft tissue thickness inwardly in a direction towards the bone.
  • the means for generating a single digital project file may comprise means for combining obtained digital information in a single digital project visualisable on a display screen.
  • the computer system may furthermore comprise means for importing the digital project file into implant planning software.
  • a method for creating a personalized digital planning environment for simulation of dental implant placement comprising: - digitising intra-oral surface anatomy of a patient, - generating an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, - taking a two-dimensional dental X-ray image of the potential dental implant receptor sites and mapping it along at least part of a dental arch of the digitised intra-oral surface anatomy,
  • carrier medium and "computer readable medium” as used herein refer to any medium that participates in providing instructions to a processor for execution. Such a medium may take many forms, including but not limited to, non-volatile media, volatile media, and transmission media.
  • Nonvolatile media includes, for example, optical or magnetic disks, such as a storage device which is part of mass storage.
  • Volatile media includes dynamic memory such as RAM.
  • Transmission media include coaxial cables, copper wire and fiber optics, including the wires that comprise a bus within a computer. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infra-red data communications.
  • Computer readable media include, for example a floppy disk, a flexible disk, a hard disk, magnetic tape, or any other magnetic medium, a CD-ROM, any other optical medium, punch cards, paper tapes, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH-EPROM, any other memory chip or cartridge, a carrier wave as described hereafter, or any other medium from which a computer can read.
  • Various forms of computer readable media may be involved in carrying one or more sequences of one or more instructions to a processor for execution.
  • the instructions may initially be carried on a magnetic disk of a remote computer.
  • the remote computer can load the instructions into its dynamic memory and send the instructions over a telephone line using a modem.
  • a modem local to the computer system can receive the data on the telephone line and use an infrared transmitter to convert the data to an infrared signal.
  • An infrared detector coupled to a bus can receive the data carried in the infra-red signal and place the data on the bus.
  • the bus carries data to main memory, from which a processor retrieves and executes the instructions.
  • main memory may optionally be stored on a storage device either before or after execution by a processor.
  • the instructions can also be transmitted via a carrier wave in a network, such as a LAN, a WAN or the internet.
  • Transmission media can take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications. Transmission media include coaxial cables, copper wire and fibre optics, including the wires that form a bus within a computer. It is an advantage of embodiments of the present invention that no volumetric scan such as CT or CT-like scanning needs to be performed in order to obtain the required information.
  • Fig. 1 shows two cross-sections of parts of jawbones which would generate equal X-ray images.
  • Fig. 2 shows a 3D plaster model of a dental arch.
  • Fig. 3 illustrates part of a jawbone covered with soft tissue and an impression material, needles for measuring the soft tissue thickness being provided through the impression material and the soft tissue.
  • Fig. 4 illustrates an impression tray which can be used for measuring the soft tissue thickness in accordance with embodiments of the invention.
  • Fig. 5 shows an X-ray image of a mouth of a patient.
  • Fig. 6 front view
  • Fig. 7 top view
  • Fig. 8 illustrates the mapping of a panoramic X-ray image on a 3D representation of the intra-oral surface anatomy.
  • Fig. 9 illustrates a set-up with needles for determining soft tissue thickness.
  • Fig. 10 illustrates determined bone structure of the jaw, obtained by offsetting the known soft tissue surface inward over a distance known from the measurements of soft tissue thickness.
  • Fig. 11 illustrates mapping an X-ray image with the determined bone structure.
  • Fig. 12 illustrates addition of a digital representation of an ideal tooth set-up in a receptor site, to aid in the decision where and how to place the implants.
  • Fig. 13 illustrates a processing system which can be used with methods according to embodiments of the present invention.
  • FIG. 13 shows one configuration of processing system 1500 that includes at least one programmable processor 1503 coupled to a memory subsystem 1505 that includes at least one form of memory, e.g., RAM, ROM, and so forth.
  • a storage subsystem 1507 may be included that has at least one disk drive and/or CD-ROM drive and/or DVD drive.
  • a display system, a keyboard, and a pointing device may be included as part of a user interface subsystem 1509 to provide for a user to manually input information. Ports for inputting and outputting data also may be included.
  • FIG. 13 More elements such as network connections, interfaces to various devices, and so forth, may be included, but are not illustrated in Fig. 13.
  • the various elements of the processing system 1500 may be coupled in various ways, including via a bus subsystem 1513 shown in Fig. 13 for simplicity as a single bus, but will be understood to those in the art to include a system of at least one bus.
  • the memory of the memory subsystem 1505 may at some time hold part or all (in either case shown as 1511 ) of a set of instructions that when executed on the processing system 1500 implement the step(s) of the method embodiments described herein.
  • a processing system 1500 such as shown in Fig. 13 is prior art
  • a system that includes the instructions to implement novel aspects of the present invention is not prior art, and therefore Fig. 13 is not labelled as prior art.
  • processor 1503 or processors may be a general purpose, or a special purpose processor, and may be for inclusion in a device, e.g., a chip that has other components that perform other functions. Also with developments such devices may be replaced by any other suitable processing engine, e.g. an FPGA.
  • processors may be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations of them.
  • aspects of the invention can be implemented in a computer program product tangibly embodied in a carrier medium carrying machine-readable code for execution by a programmable processor. Method steps of aspects of the invention may be performed by a programmable processor executing instructions to perform functions of those aspects of the invention, e.g., by operating on input data and generating output data.
  • aspects of the invention can be implemented in a computer program product tangibly embodied in a carrier medium carrying machine-readable code for execution by a programmable processor.
  • carrier medium refers to any medium that participates in providing instructions to a processor for execution. Such a medium may take many forms, including but not limited to, non-volatile media, and transmission media.
  • Non volatile media includes, for example, optical or magnetic disks, such as a storage device which is part of mass storage.
  • Volatile media includes mass storage.
  • Volatile media includes dynamic memory such as RAM.
  • Common forms of computer readable media include, for example a floppy disk, a flexible disk, a hard disk, magnetic tape, or any other magnetic medium, a CD-ROM, any other optical medium, punch cards, paper tapes, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM 1 a FLASH- EPROM, any other memory chip or cartridge, a carrier wave as described hereafter, or any other medium from which a computer can read.
  • Various forms of computer readable media may be involved in carrying one or more sequences of one or more instructions to a processor for execution.
  • the instructions may initially be carried on a magnetic disk of a remote computer.
  • the remote computer can load the instructions into its dynamic memory and send the instructions over a telephone line using a modem.
  • a modem local to the computer system can receive the data on the telephone line and use an infrared transmitter to convert the data to an infrared signal.
  • An infrared detector coupled to a bus can receive the data carried in the infrared signal and place the data on the bus.
  • the bus carries data to main memory, from which a processor retrieves and executes the instructions.
  • the instructions received by main memory may optionally be stored on a storage device either before or after execution by a processor.
  • the instructions can also be transmitted via a carrier wave in a network, such as a LAN, a WAN or the Internet. Transmission media can take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications.
  • Transmission media include coaxial cables, copper wire and fibre optics, including the wires that comprise a bus within a computer.
  • the present invention provides a method for creating a personalized digital planning environment for simulation of dental implant placement without requiring the use of volumetric imaging techniques such as e.g. CT (computed tomography), cone-beam CT imaging or MRI (magnetic resonance imaging). Therefore, patient specific information, which may possibly be obtained from different sources such as e.g. optical scanning, digital photography, non- volumetric X-ray etc., may be combined in a digital manner for obtaining a single digital project that can be used by e.g. a clinician in maxillofacial planning software for the purpose of simulating a surgical intervention such as dental implant placement.
  • volumetric imaging techniques such as e.g. CT (computed tomography), cone-beam CT imaging or MRI (magnetic resonance imaging). Therefore, patient specific information, which may possibly be obtained from different sources such as e.g. optical scanning, digital photography, non- volumetric
  • the method comprises different steps.
  • these different steps will be described by means of different embodiments.
  • a first step of the method according to the present invention comprises digitizing an intra-oral topography or surface anatomy of a patient.
  • this information may be obtained at least for possible implant receptor sites, i.e. for places where no teeth are present anymore.
  • this information may be obtained for an entire dental arch of a lower and/or upper jawbone of the patient, this means locations where teeth are still present together with the locations where no teeth are present anymore and where implants may have to be provided.
  • obtaining this information may be done directly, for example by performing an optical scan in the mouth of the patient, e.g. a 3D optical surface scan.
  • obtaining this information may also be done indirectly, for example by taking an impression of the upper and/or lower jaw, converting this impression into a stone or plaster model and digitally capturing spatial coordinates of the intra-oral surface from the stone or plaster model.
  • the latter may be done by means of, for example, a mechanical digitizer, a laser scanner, stereo photography or laser holography.
  • Fig. 2 shows a plaster model of a dental arch 1 comprising potential dental implant receptor sites 2, or locations without teeth 3, and locations 4 where teeth 3 are still present.
  • a second step of the method therefore comprises acquiring information about the thickness of the soft tissue, at least in the region of and around potential dental implant receptor sites 2, this, however, without making use of volumetric imaging techniques such as CT, cone-beam CT or MRI.
  • information about the thickness of the soft tissue may be obtained via statistical information from an expert system.
  • the expert system may comprise a database of information about typical soft tissue thickness distributions in different cross-sections along the jaw taken from a representative sample of the population, e.g. recorded depending upon relevant parameters such as age, sex, weight, relevant dimensions of the human subject, e.g. dimensions of patient anatomy, diseases (e.g. gingivitis), etc.
  • relevant parameters such as age, sex, weight, relevant dimensions of the human subject, e.g. dimensions of patient anatomy, diseases (e.g. gingivitis), etc.
  • statistics may be available for facial soft tissue thickness, based on measurements on cadavers and described in, for example, Domaracki M.,Stephan C.:"Facial Soft Tissue Thicknesses in Australian Adult Cadavers", J Forensic Sci, January 2006, Vol. 51 , No.
  • Such a database may be analysed according to well know statistical techniques to obtain representative values with an optional standard deviation to assist in making decisions.
  • Such captured soft tissue thicknesses or thickness distributions can be correlated with the soft tissue thickness visible in projection in the axial direction of an X-ray image, i.e. from the crest of the jawbone to the delineated gingival level.
  • the expert system may take information into account, and/or provide information about, variations in soft tissue distributions related to suitable parameters, e.g. age, gender, diseases (e.g. gingivitis), patient anatomy, etc.
  • the thickness of the soft tissue may be measured using a depth gauge such as, for example, at least one hypodermic needle 5 or the like, in discrete points.
  • a depth gauge such as, for example, at least one hypodermic needle 5 or the like, in discrete points.
  • the depth gauge e.g. hypodermic needle(s) 5
  • the depth gauge may be provided through a silicone or alginate impression material 8 which is seated in the mouth of the patient.
  • a set of hypodermic needles 5 may then be used which remain fixed in the impression material 8 after removal form a patient's mouth.
  • the hypodermic needles 5 indicate the direction of the measurement while the level (depth) of intrusion in the soft tissue 7 can be determined relative to the remaining dentition or other reference points in the jaw such as, for example, old or temporary implants.
  • an impression tray 9 with gauging cylinders 10 for guiding the hypodermic needle(s) 5 along a predetermined path may be used. This is illustrated in Fig. 4.
  • the impression tray 9 may be filled with an impression material, such as e.g. silicone or alginate paste (not shown in Fig. 4), and the patient bites down on it to create an impression in the impression material. This is identical to known, conventional ways of working. Measurements may be performed through the impression tray 9 and the impression material and may be recorded. According to yet another embodiment, ultrasound measurements may be used to locally quantify the thickness of the soft tissue 7. Ultrasound thickness measurements are well known to a person skilled in the art.
  • the present invention also includes using a combination of two or more of the methods mentioned above.
  • one method may be used as a main method and a second method used for corroboration of the results. This may be advantageous when the main method does not provide enough or accurate points. These can then be improved by regression against known values from an expert system, for example.
  • a two- dimensional (2D) dental X-ray image of at least the potential dental receptor sites 2, but preferably of the entire dental arch 1 is acquired, and the thereby obtained image is mapped along at least part of the dental arch 1 as determined on the 3D digital representation of the intro-oral topography, e.g. the 3D digital representation of the plaster model.
  • the 2D dental X-ray image may be mapped along the entire dental arch 1 , thereby providing a 2D dental X-ray image map of all locations 4 with teeth 3 or old or temporary implants and all locations providing potential dental receptor sites 2.
  • Fig. 5 illustrates a dental X-ray image 11 of a complete mouth of a patient, i.e. of the upper jaw 12 and lower jaw 13 showing potential dental implant receptor cites 2 and locations where teeth 3, or possibly old or temporary implants, are present.
  • mapping of the X-ray image to the patient anatomy may be performed including non-uniform (may be linear or non-linear) scaling and deformation of the X-ray image 11. Therefore, the X-ray film 11 may be interpreted as being folded along a curved internal surface of the dental arch 1 , the curved surface following the arch 1 of the jaw. This is illustrated in Fig. 6 (front view) and 7 (top view).
  • the 2D dental X-ray image 11 may be a panoramic X-ray image. As the panoramic X-ray image may be subject to magnification errors and errors due to the variation of the patient from the scanning equipment or even displacement of the patient while taking the X-ray image, distortions may be present in the 2D dental X-ray image 11.
  • the mapping method must allow non-uniform stretching of the X-ray image 11.
  • a possible approach may be to indicate pairs of corresponding points with a first point of the pair on the X-ray image 11 and a second point of the same pair on the 3D representation obtained during the first step of the method. Where these points are indicated, the correspondence between the X-ray image 11 and the 3D representation will be accurate.
  • the X-ray image 11 may be interpolated, respectively extrapolated, to obtain minimal distortion of the X-ray image 11.
  • RBF Random Base Function
  • mapping may be performed in a linear manner according to the axial direction or Z-direction, i.e. the apical-coronal direction relative to the teeth, and in a non-linear manner in the horizontal or X- direction.
  • mapping may be performed in a linear manner in the Z- direction because typically X-ray images are relatively accurate in the Z- direction (see 'Implants and Restorative Dentistry', Chapter 11 - Imaging in oral implantology, page 178 mentioned above), in which it is described that performing measurements in the X-direction is not reliable, but performing measurements in the Z-direction is reliable.
  • Performing measurements in the Y-dimension does not give data.
  • the mapping may be based on a calibration element with known length and visible in the X-ray image along the Z-direction. Such fiducial markers are known to the skilled person.
  • a 3D surface model of the jawbone at potential dental implant receptor sites 2 is created based on the soft tissue thickness information acquired during the second step of the method according to the invention, at the region of and around potential dental implant receptor sites 2.
  • this creating of a 3D surface model of the jawbone may be made by offsetting from the soft tissue surface, known from the digitized plaster model or the optical scan, in an inward direction, i.e. from the soft tissue surface towards the underlying bone.
  • This offset is over distances known from statistical values provided in the second step or from the measurements performed in the second step (see Fig. 9).
  • the exact offset value may be known for tissue points lying on the measurement axes, i.e. the axes determined by the hypodermic needles and their placement in the soft tissue during measurement. For the other points, i.e.
  • the offset value may be interpolated between known offset values in the discrete measuring points. Any suitable interpolation method can be used, e.g. polynomial interpolation.
  • the result is a 3D surface model of the jawbone at the region of and around potential dental implant receptor sites 2 as illustrated in Fig. 10.
  • the thickness of the soft tissue 7 may be measured on the available X-ray image 11 in different points along the dental arch 1. These measurements may be transferred to the 3D digital representation of the intra-oral topology and may be assumed constant in a section perpendicular to the dental arch 1 , i.e. in the cross- sections or the observed values may be input into the expert system mentioned above and used to obtain adjusted values of the soft tissue thickness by extrapolating known values to values at other positions not visible on the X-ray image.
  • the digital representation of the bone may be generated starting from the cross-section of the digital representation of the 3D stone or plaster model or of the optical scan, i.e. the intra-oral topography with soft tissue being present.
  • a set of contours is obtained defining the shape of the bone of the jaw.
  • these contours can be used to generate a 3D representation of the bone of the jaw.
  • lofting operation is meant connecting two polygonal contours together with a triangular mesh, in that way producing a surface.
  • a hollowing operation may be applied to the 3D representation of the stone or plaster model or to the optical scan that forms the 3D model of the intra-oral topography with soft tissue in place.
  • Such a hollowing operation creates an inner surface that is uniformly offset relative to the stone or plaster model.
  • This inner surface may be regarded as a simplified representation of the bone assuming a constant thickness of the soft tissue 7 over the entire jaw.
  • a fifth step of the method according to the present invention is generating a single digital project file that comprises a combination of at least the digital representation of the plaster model or the optical scan, i.e. of the intra-oral topography, the mapped X-ray image and the digital representation of the bone at the potential dental implant receptor sites 2 as obtained in the previous steps (see Fig. 11 ).
  • This project file can be imported and used in implant planning software, for example SimPlantTM, provided by Materialise, Belgium, for the purpose of simulating implant placement.
  • the fifth step of the method according to the present invention comprises combining digital information obtained in former steps in a single digital project file to be visualised on a display, e.g. computer screen or printed on a printing device such as a plotter.
  • a digital representation of the ideal tooth set-up in the receptor sites 2 may be added, for example from a digital tooth library, to aid in the decision of where and how to place the implants 15, as illustrated in Fig. 12.
  • the digital representation of the intra-oral topography e.g. plaster model or optical scan
  • the digital representation of the intra-oral topography may be used to design and produce dedicated surgical templates to assist the surgeon in transferring the implant plan to the patient during a surgical intervention.
  • An advantage of the present invention is that it does not require costly CT equipment and measurements, while still providing information about the bone structure.
  • CT equipment is not always readily available so that there are dentists who do not have access to CT equipment.
  • the present invention therefore provides a safe and more easily available method for creating a personalized digital planning file for simulation of dental implant placement.
  • the method according to the present invention allows mapping of an X-ray image to the 3D model of the intra-oral topography in the axial direction or Z-direction, i.e. the apical-coronal direction relative to the teeth, and allows mapping by non-linear scaling and deformation of the X-ray image in the X-direction.

Abstract

The present invention provides a method for creating a personalized digital planning file for simulation of dental implant placement. After planning, the digital representation in a plaster model may be used to design and produce dedicated surgical templates to assist the surgeon in transferring the implant plan to a patient during medical intervention.

Description

METHOD FOR CREATING A PERSONALIZED DIGITAL PLANNING FILE FOR SIMULATION OF DENTAL IMPLANT
PLACEMENT
Technical field of the invention The present invention relates to simulation of dental implant placement and more particularly relates to a method for creating a personalized digital planning file for simulation of dental implant placement as well as software for carrying out any of these methods and to computer systems implementing these methods.
Background of the invention
Surgical planning for dental implant placement traditionally uses medical imaging modalities to verify the quantity and quality of a jawbone. Multi-planar reformatted CT (computed tomography) has become one of the most comprehensive and accurate aids for implant treatment planning. CT offers means to visualise the oral anatomy of a patient in a number of differently oriented slices of a volumetric scan and to graphically superimpose on the images representations of commercial implants of varying length, diameter and brand (for example, SimPlant™ provided by Materialise, Leuven, Belgium).
According to the current state of the art a patient is sent to a radiologist for a CT scan. The result of the scan is a stack of 2D slices forming a three- dimensional volumetric "data set" which can then be used as input for a dental planning program. Typically, such a program imports the data set provided by a radiology site without altering any information. Using image-processing techniques such as, for example, image segmentation, three-dimensional models of the bone may be derived from the data set. In the planning environment, the practitioner subsequently defines a curve that follows the arch of the jaw. Several cross-sections can be chosen perpendicular to both the panoramic curve and the axial slices. Typically, implant receptor sites may be chosen in these cross- sections. The practitioner can modify the positions and inclinations of each implant as needed in any of the views, including the 3D view. Fine tuning is performed by shifting and tilting of the implant representations or by changing their dimensions. Each individual implant position can be evaluated in terms of the volume of available bone and its quality. The latter is interpretable in CT images by means of the number of Hounsfield units attributed to each of the voxels, i.e. volumetric building blocks of the CT images. Disadvantages of using CT for dental implant planning are the additional costs related to scanning and the fact that significant irradiation of the patient is required in order to obtain the volumetric data. Moreover CT or CT-like scanning equipment, such as e.g. cone-beam scanners, is costly and has yet to be widely used in the dental market. Scanning equipment is therefore not always readily available.
To overcome these disadvantages methods for simulating dental implant placement without resorting to volumetric image data such as CT, cone-beam scans, MRI scans, have been proposed.
US 6,319,006 describes a method for producing a drill assistance device for a tooth implant in which an X-ray image is correlated with a three- dimensional image of optically measured visible parts of a patient's remaining dentition. The method comprises taking an X-ray picture of the jaw and the compilation of corresponding measured data record, a three-dimensional, optical measurement of the visible surfaces of the jaw and of the teeth and the compilation of a corresponding measured data record. The measured data records from the X-ray picture and the measured data records from the three- dimensional, optical image are correlated with each other. Based on the information that is available, the type and position of the implant relative to the adjacent teeth is planned and a drill template is produced which is attached to the neighbouring teeth, thus making the exact drilling of an implant pilot hole possible.
However, a disadvantage of this way of working is the lack of three- dimensional information about the shape of the jawbone. While the X-ray image provides information about the bone in a projected image, it does not provide insights about the level of the bone in cross section along the dental arch. As an example, Fig. 1 shows two exemplary cross-sections of a jawbone, which on a frontal X-ray image would both be visualized identically. However the bone in both sections is very different as can be seen from Fig. 1. In WO 2004/064660 a method for dental registration is provided. The method comprises rigidly coupling a base element to a maxillofacial area, inserting an object comprising at least one of a tool and a tool guide into a mouth in the maxillofacial area, and determining a position of the object relative to the rigid element without a reference element outside the mouth. According to embodiments, the method may comprise combining two non- volumetric images of at least part of the maxillofacial area. The non-volumetric images can be obtained by X-ray, optical scan data or direct bone surface measurements. The method may comprise acquiring the first non-volumetric image including at least a part of the base element, identifying at least one registration mark of the rigid element and registering the image to the second non-volumetric image, thereby registering the registration mark to the area.
The method described in WO 2004/064660 is tedious and not so practically convenient because a foreign object, i.e. the base element, needs to be introduced into the mouth and rigidly coupled to the jaw. The object furthermore needs to be present in the mouth during the imaging. Moreover, the technique does not take into account the fact that X-ray images inherently are inaccurate in the lateral direction, as disclosed in the book "Implants and Restorative Dentistry", Chapter 11 - Imaging in oral implantology, page 178. A registration according to the described technique would not compensate for these inaccuracies.
Summary of the invention
It is an object of the present invention to provide a good method and apparatus for creating a personalized digital planning file for simulation of dental implant placement.
The above objective is accomplished by a method according to the present invention.
In a first aspect of the invention, a method is provided for creating a personalized digital planning environment for simulation of dental implant placement from (i) a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, (ii) an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, and (iii) a two-dimensional dental X-ray image of the potential dental implant receptor sites, the method comprising:
- mapping the two-dimensional dental X-ray image of the potential dental implant receptor sites along at least part of a dental arch of the digitized intra-oral surface anatomy,
- constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites based on the at least point-wise digital representation of soft tissue thickness, and
- generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three-dimensional surface model of the bone at the potential dental implant receptor sites.
An advantage of the present invention is that it does not require costly CT equipment and measurements, while still providing information about the bone structure.
The method according to embodiments of the present invention does not require the use of volumetric imaging techniques such as e.g. CT
(computed tomography), cone-beam CT imaging or MRI (magnetic resonance imaging). As CT scans submit the patient to a significant radiation loading, avoiding them is advantageous for the patient. Patient specific information, which may possibly be obtained from different sources such as e.g. optical scanning, digital photography, non-volumetric X-ray etc., may be combined in a digital manner for obtaining a single digital project that can be used by e.g. a clinician in maxillofacial planning software for the purpose of simulating a surgical intervention such as dental implant placement.
The digitized representation of an intra-oral surface anatomy may be investigated for possible dental implant receptor sites.
The digitized representation of an intra-oral surface anatomy may be for the entire dental arch of the upper jaw and/or lower jaw. According to embodiment of the invention, the digitized representation of an intra-oral surface anatomy may be a surface scan, e.g. an optical scan, e.g. optical surface scan, of the mouth of the patient. According to other embodiments of the invention, the digitized representation of an intra-oral surface anatomy may be obtained from an impression of the upper jaw and/or lower jaw, whereby this impression may be used to digitally capture spatial coordinates of the intra-oral surface. The digital representation of the soft tissue may be obtained via statistical information from an expert system.
According to other embodiments, the soft tissue may have a thickness and the digital representation of the soft tissue thickness may be obtained via local measurements of the thickness of the soft tissue. According to embodiments of the invention, the local measurements of the thickness of the soft tissue may be obtained by using a depth gauge, such as, for example at least one hypodermic needle. According to other embodiments of the invention, the local measurements of the thickness of the soft tissue may, for example, be obtained from ultrasound measurements. According to embodiments of the invention, there being a curved surface following the dental arc, mapping the dental X-ray image along at least part of the dental arch may be performed by folding the dental X-ray image along the curved surface.
Mapping the dental X-ray image along at least part of the dental arch may comprise indicating corresponding points on the dental X-ray image and on the intra-oral surface anatomy.
Mapping the dental X-ray image along at least part of the dental arch may comprise non-uniform stretching of the X-ray image.
According to embodiments of the invention, mapping the dental X-ray image along at least part of the dental arch may include linear scaling of the X- ray image in the apical-coronal-direction or Y-direction of the patient. According to other embodiments of the invention, mapping the dental X-ray image along at least part of the dental arch may include non-linear scaling of the X-ray image in the horizontal direction or X-direction. Constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may be performed by offsetting the soft tissue thickness inwardly in a direction towards the jawbone. Generating a single digital project file comprising information obtained in the previous steps may be performed by combining obtained digital information in a single digital project visualisable on a display screen.
According to embodiments of the invention, the method may furthermore comprise importing the digital project file into implant planning software.
In a second aspect of the invention, a computer program product is provided for executing any of the methods according to the present invention when executed on a computing device associated with a simulation device for simulation of dental implant placement.
The present invention also provides a machine readable data storage device storing the computer program product according to the present invention.
Furthermore, the present invention provides transmission of the computer program product according to the present invention over a local or wide area telecommunications network.
The present invention furthermore provides a computer system for creating a personalized digital planning environment for simulation of dental implant placement from (i) a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, (ii) an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, and (iii) a two-dimensional dental X-ray image of the potential dental implant receptor sites, the system comprising: - means for mapping the two-dimensional dental X-ray image of the potential dental implant receptor sites along at least part of a dental arch of the digitised intra-oral surface anatomy,
- means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites based on the at least point-wise digital representation of soft tissue thickness, and
- means for generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three-dimensional surface model of the bone at the potential dental implant receptor sites.
The means for mapping the two-dimensional dental X-ray image may comprise means for investigating for possible dental implant receptor sites. The means for mapping the two-dimensional dental X-ray image may comprises mean for performing a surface scan of the mouth of a patient.
The means for mapping the two-dimensional dental X-ray image may comprise means for performing linear scaling of the X-ray image in the apical- coronal direction of the patient. The means for mapping the two-dimensional dental X-ray image may comprise means for performing non-linear scaling of the X-ray image in the horizontal direction.
The soft tissue may have a thickness and the means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may comprise means for local measurement of the thickness of the soft tissue.
The means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites may comprise means for performing offsetting the soft tissue thickness inwardly in a direction towards the bone.
The means for generating a single digital project file may comprise means for combining obtained digital information in a single digital project visualisable on a display screen.
The computer system may furthermore comprise means for importing the digital project file into implant planning software.
In still a further aspect of the present invention, a method is provided for creating a personalized digital planning environment for simulation of dental implant placement, the method comprising: - digitising intra-oral surface anatomy of a patient, - generating an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites, - taking a two-dimensional dental X-ray image of the potential dental implant receptor sites and mapping it along at least part of a dental arch of the digitised intra-oral surface anatomy,
- constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites based on the at least point-wise digital representation of soft tissue thickness, and
- generating a single digital project file comprising information obtained in the previous steps.
The terms "carrier medium" and "computer readable medium" as used herein refer to any medium that participates in providing instructions to a processor for execution. Such a medium may take many forms, including but not limited to, non-volatile media, volatile media, and transmission media. Nonvolatile media includes, for example, optical or magnetic disks, such as a storage device which is part of mass storage. Volatile media includes dynamic memory such as RAM. Transmission media include coaxial cables, copper wire and fiber optics, including the wires that comprise a bus within a computer. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infra-red data communications. Common forms of computer readable media include, for example a floppy disk, a flexible disk, a hard disk, magnetic tape, or any other magnetic medium, a CD-ROM, any other optical medium, punch cards, paper tapes, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH-EPROM, any other memory chip or cartridge, a carrier wave as described hereafter, or any other medium from which a computer can read.
Various forms of computer readable media may be involved in carrying one or more sequences of one or more instructions to a processor for execution. For example, the instructions may initially be carried on a magnetic disk of a remote computer. The remote computer can load the instructions into its dynamic memory and send the instructions over a telephone line using a modem. A modem local to the computer system can receive the data on the telephone line and use an infrared transmitter to convert the data to an infrared signal. An infrared detector coupled to a bus can receive the data carried in the infra-red signal and place the data on the bus. The bus carries data to main memory, from which a processor retrieves and executes the instructions. The instructions received by main memory may optionally be stored on a storage device either before or after execution by a processor. The instructions can also be transmitted via a carrier wave in a network, such as a LAN, a WAN or the internet. Transmission media can take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications. Transmission media include coaxial cables, copper wire and fibre optics, including the wires that form a bus within a computer. It is an advantage of embodiments of the present invention that no volumetric scan such as CT or CT-like scanning needs to be performed in order to obtain the required information.
Particular and preferred aspects of the invention are set out in the accompanying independent and dependent claims. Features from the dependent claims may be combined with features of the independent claims and with features of other dependent claims as appropriate and not merely as explicitly set out in the claims.
The above and other characteristics, features and advantages of the present invention will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the invention. This description is given for the sake of example only, without limiting the scope of the invention. The reference figures quoted below refer to the attached drawings.
Brief description of the drawings Fig. 1 shows two cross-sections of parts of jawbones which would generate equal X-ray images.
Fig. 2 shows a 3D plaster model of a dental arch. Fig. 3 illustrates part of a jawbone covered with soft tissue and an impression material, needles for measuring the soft tissue thickness being provided through the impression material and the soft tissue.
Fig. 4 illustrates an impression tray which can be used for measuring the soft tissue thickness in accordance with embodiments of the invention. Fig. 5 shows an X-ray image of a mouth of a patient.
Fig. 6 (front view) and Fig. 7 (top view) illustrate how an X-ray film is folded on a curved surface that follows the arch of the jaw of a patient, for obtaining a panoramic X-ray image. Fig. 8 illustrates the mapping of a panoramic X-ray image on a 3D representation of the intra-oral surface anatomy.
Fig. 9 illustrates a set-up with needles for determining soft tissue thickness.
Fig. 10 illustrates determined bone structure of the jaw, obtained by offsetting the known soft tissue surface inward over a distance known from the measurements of soft tissue thickness.
Fig. 11 illustrates mapping an X-ray image with the determined bone structure.
Fig. 12 illustrates addition of a digital representation of an ideal tooth set-up in a receptor site, to aid in the decision where and how to place the implants.
Fig. 13 illustrates a processing system which can be used with methods according to embodiments of the present invention.
In the different figures, the same reference signs refer to the same or analogous elements.
Description of illustrative embodiments
The present invention will be described with respect to particular embodiments and with reference to certain drawings but the invention is not limited thereto but only by the claims. The drawings described are only schematic and are non-limiting. In the drawings, the size of some of the elements may be exaggerated and not drawn on scale for illustrative purposes. The dimensions and the relative dimensions do not correspond to actual reductions to practice of the invention.
Furthermore, the terms first, second, third and the like in the description and in the claims, are used for distinguishing between similar elements and not necessarily for describing a sequential or chronological order. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other sequences than described or illustrated herein.
Moreover, the terms top, bottom and the like in the description and the claims are used for descriptive purposes and not necessarily for describing relative positions. It is to be understood that the terms so used are interchangeable under appropriate circumstances and that the embodiments of the invention described herein are capable of operation in other orientations than described or illustrated herein.
It is to be noticed that the term "comprising", used in the claims, should not be interpreted as being restricted to the means listed thereafter; it does not exclude other elements or steps. It is thus to be interpreted as specifying the presence of the stated features, integers, steps or components as referred to, but does not preclude the presence or addition of one or more other features, integers, steps or components, or groups thereof. Thus, the scope of the expression "a device comprising means A and B" should not be limited to devices consisting only of components A and B. It means that with respect to the present invention, the only relevant components of the device are A and B.
The invention will now be described by a detailed description of several embodiments of the invention. It is clear that other embodiments of the invention can be configured according to the knowledge of persons skilled in the art without departing from the true spirit or technical teaching of the invention, the invention being limited only by the terms of the appended claims.
Several embodiments of methods for creating a personalised digital planning file for simulation of a dental implant placement are now described. Such method embodiments may be implemented in a processing system 1500 such as shown in Fig. 13. Fig. 13 shows one configuration of processing system 1500 that includes at least one programmable processor 1503 coupled to a memory subsystem 1505 that includes at least one form of memory, e.g., RAM, ROM, and so forth. A storage subsystem 1507 may be included that has at least one disk drive and/or CD-ROM drive and/or DVD drive. In some implementations, a display system, a keyboard, and a pointing device may be included as part of a user interface subsystem 1509 to provide for a user to manually input information. Ports for inputting and outputting data also may be included. More elements such as network connections, interfaces to various devices, and so forth, may be included, but are not illustrated in Fig. 13. The various elements of the processing system 1500 may be coupled in various ways, including via a bus subsystem 1513 shown in Fig. 13 for simplicity as a single bus, but will be understood to those in the art to include a system of at least one bus. The memory of the memory subsystem 1505 may at some time hold part or all (in either case shown as 1511 ) of a set of instructions that when executed on the processing system 1500 implement the step(s) of the method embodiments described herein. Thus, while a processing system 1500 such as shown in Fig. 13 is prior art, a system that includes the instructions to implement novel aspects of the present invention is not prior art, and therefore Fig. 13 is not labelled as prior art.
It is to be noted that the processor 1503 or processors may be a general purpose, or a special purpose processor, and may be for inclusion in a device, e.g., a chip that has other components that perform other functions. Also with developments such devices may be replaced by any other suitable processing engine, e.g. an FPGA. Thus, one or more aspects of the present invention can be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations of them. Furthermore, aspects of the invention can be implemented in a computer program product tangibly embodied in a carrier medium carrying machine-readable code for execution by a programmable processor. Method steps of aspects of the invention may be performed by a programmable processor executing instructions to perform functions of those aspects of the invention, e.g., by operating on input data and generating output data.
Furthermore, aspects of the invention can be implemented in a computer program product tangibly embodied in a carrier medium carrying machine-readable code for execution by a programmable processor. The term "carrier medium" refers to any medium that participates in providing instructions to a processor for execution. Such a medium may take many forms, including but not limited to, non-volatile media, and transmission media. Non volatile media includes, for example, optical or magnetic disks, such as a storage device which is part of mass storage. Volatile media includes mass storage. Volatile media includes dynamic memory such as RAM. Common forms of computer readable media include, for example a floppy disk, a flexible disk, a hard disk, magnetic tape, or any other magnetic medium, a CD-ROM, any other optical medium, punch cards, paper tapes, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM1 a FLASH- EPROM, any other memory chip or cartridge, a carrier wave as described hereafter, or any other medium from which a computer can read. Various forms of computer readable media may be involved in carrying one or more sequences of one or more instructions to a processor for execution. For example, the instructions may initially be carried on a magnetic disk of a remote computer. The remote computer can load the instructions into its dynamic memory and send the instructions over a telephone line using a modem. A modem local to the computer system can receive the data on the telephone line and use an infrared transmitter to convert the data to an infrared signal. An infrared detector coupled to a bus can receive the data carried in the infrared signal and place the data on the bus. The bus carries data to main memory, from which a processor retrieves and executes the instructions. The instructions received by main memory may optionally be stored on a storage device either before or after execution by a processor. The instructions can also be transmitted via a carrier wave in a network, such as a LAN, a WAN or the Internet. Transmission media can take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications. Transmission media include coaxial cables, copper wire and fibre optics, including the wires that comprise a bus within a computer. The present invention provides a method for creating a personalized digital planning environment for simulation of dental implant placement without requiring the use of volumetric imaging techniques such as e.g. CT (computed tomography), cone-beam CT imaging or MRI (magnetic resonance imaging). Therefore, patient specific information, which may possibly be obtained from different sources such as e.g. optical scanning, digital photography, non- volumetric X-ray etc., may be combined in a digital manner for obtaining a single digital project that can be used by e.g. a clinician in maxillofacial planning software for the purpose of simulating a surgical intervention such as dental implant placement.
According to the present invention, the method comprises different steps. Hereinafter, these different steps will be described by means of different embodiments.
A first step of the method according to the present invention comprises digitizing an intra-oral topography or surface anatomy of a patient. In other words, the geometry of remaining teeth and soft tissue is digitized in this first step of the method. According to embodiments of the present invention, this information may be obtained at least for possible implant receptor sites, i.e. for places where no teeth are present anymore. According to other embodiments of the invention, this information may be obtained for an entire dental arch of a lower and/or upper jawbone of the patient, this means locations where teeth are still present together with the locations where no teeth are present anymore and where implants may have to be provided.
According to embodiments of the invention, obtaining this information may be done directly, for example by performing an optical scan in the mouth of the patient, e.g. a 3D optical surface scan. According to other embodiments of the invention, obtaining this information may also be done indirectly, for example by taking an impression of the upper and/or lower jaw, converting this impression into a stone or plaster model and digitally capturing spatial coordinates of the intra-oral surface from the stone or plaster model. The latter may be done by means of, for example, a mechanical digitizer, a laser scanner, stereo photography or laser holography. Fig. 2 shows a plaster model of a dental arch 1 comprising potential dental implant receptor sites 2, or locations without teeth 3, and locations 4 where teeth 3 are still present.
The detailed information about the geometry of the remaining dentition and the soft tissue may then be imported into a computer workstation running 3D graphics software. A three-dimensional surface representation of the jaw is thereby obtained. Since the digitization is limited to capturing of the surface geometry, no information is directly available about the position of the jawbone in 3D hidden under the soft tissue after performing this first step of the method according to the invention. A second step of the method therefore comprises acquiring information about the thickness of the soft tissue, at least in the region of and around potential dental implant receptor sites 2, this, however, without making use of volumetric imaging techniques such as CT, cone-beam CT or MRI. According to one embodiment of the present invention, information about the thickness of the soft tissue may be obtained via statistical information from an expert system. Therefore, information about the thickness of the soft tissue or gum at different sites along the jaw may be imported from the expert system. The expert system may comprise a database of information about typical soft tissue thickness distributions in different cross-sections along the jaw taken from a representative sample of the population, e.g. recorded depending upon relevant parameters such as age, sex, weight, relevant dimensions of the human subject, e.g. dimensions of patient anatomy, diseases (e.g. gingivitis), etc. For example, statistics may be available for facial soft tissue thickness, based on measurements on cadavers and described in, for example, Domaracki M.,Stephan C.:"Facial Soft Tissue Thicknesses in Australian Adult Cadavers", J Forensic Sci, January 2006, Vol. 51 , No. 1 , pp. 5-10. Such a database may be analysed according to well know statistical techniques to obtain representative values with an optional standard deviation to assist in making decisions. Such captured soft tissue thicknesses or thickness distributions can be correlated with the soft tissue thickness visible in projection in the axial direction of an X-ray image, i.e. from the crest of the jawbone to the delineated gingival level. In providing values for use with the present invention the expert system may take information into account, and/or provide information about, variations in soft tissue distributions related to suitable parameters, e.g. age, gender, diseases (e.g. gingivitis), patient anatomy, etc.
According to another embodiment the thickness of the soft tissue may be measured using a depth gauge such as, for example, at least one hypodermic needle 5 or the like, in discrete points. This is illustrated in Fig. 3, which shows a part of a jawbone 6 with soft tissue 7 on top of it. Preferably, the depth gauge, e.g. hypodermic needle(s) 5, may be provided through a silicone or alginate impression material 8 which is seated in the mouth of the patient. A set of hypodermic needles 5 may then be used which remain fixed in the impression material 8 after removal form a patient's mouth. The hypodermic needles 5 indicate the direction of the measurement while the level (depth) of intrusion in the soft tissue 7 can be determined relative to the remaining dentition or other reference points in the jaw such as, for example, old or temporary implants.
Alternatively, an impression tray 9 with gauging cylinders 10 for guiding the hypodermic needle(s) 5 along a predetermined path may be used. This is illustrated in Fig. 4. The impression tray 9 may be filled with an impression material, such as e.g. silicone or alginate paste (not shown in Fig. 4), and the patient bites down on it to create an impression in the impression material. This is identical to known, conventional ways of working. Measurements may be performed through the impression tray 9 and the impression material and may be recorded. According to yet another embodiment, ultrasound measurements may be used to locally quantify the thickness of the soft tissue 7. Ultrasound thickness measurements are well known to a person skilled in the art.
The present invention also includes using a combination of two or more of the methods mentioned above. For example, one method may be used as a main method and a second method used for corroboration of the results. This may be advantageous when the main method does not provide enough or accurate points. These can then be improved by regression against known values from an expert system, for example.
During a third step of the method according to the invention, a two- dimensional (2D) dental X-ray image of at least the potential dental receptor sites 2, but preferably of the entire dental arch 1 , is acquired, and the thereby obtained image is mapped along at least part of the dental arch 1 as determined on the 3D digital representation of the intro-oral topography, e.g. the 3D digital representation of the plaster model. According to preferred embodiments of the invention, the 2D dental X-ray image may be mapped along the entire dental arch 1 , thereby providing a 2D dental X-ray image map of all locations 4 with teeth 3 or old or temporary implants and all locations providing potential dental receptor sites 2. Fig. 5 illustrates a dental X-ray image 11 of a complete mouth of a patient, i.e. of the upper jaw 12 and lower jaw 13 showing potential dental implant receptor cites 2 and locations where teeth 3, or possibly old or temporary implants, are present.
According to one embodiment of the invention, mapping of the X-ray image to the patient anatomy may be performed including non-uniform (may be linear or non-linear) scaling and deformation of the X-ray image 11. Therefore, the X-ray film 11 may be interpreted as being folded along a curved internal surface of the dental arch 1 , the curved surface following the arch 1 of the jaw. This is illustrated in Fig. 6 (front view) and 7 (top view). The 2D dental X-ray image 11 may be a panoramic X-ray image. As the panoramic X-ray image may be subject to magnification errors and errors due to the variation of the patient from the scanning equipment or even displacement of the patient while taking the X-ray image, distortions may be present in the 2D dental X-ray image 11. Especially in the horizontal direction, there may be non-linear variations in the magnification at different object depths. To obtain an accurate mapping of the panoramic X-ray image 11 with respect to the 3D representation of the treatment area, i.e. the region of and around potential dental implant receptor sites 2, the mapping method must allow non-uniform stretching of the X-ray image 11. A possible approach may be to indicate pairs of corresponding points with a first point of the pair on the X-ray image 11 and a second point of the same pair on the 3D representation obtained during the first step of the method. Where these points are indicated, the correspondence between the X-ray image 11 and the 3D representation will be accurate. In regions between the points and/or away from the points, the X-ray image 11 may be interpolated, respectively extrapolated, to obtain minimal distortion of the X-ray image 11. A mathematical optimization approach of interpolation with RBF e.g. (Radial Base Function) functions can be used to obtain this mapping. This embodiment is illustrated in Fig. 8.
According to embodiments the mapping may be performed in a linear manner according to the axial direction or Z-direction, i.e. the apical-coronal direction relative to the teeth, and in a non-linear manner in the horizontal or X- direction. Preferably, mapping may be performed in a linear manner in the Z- direction because typically X-ray images are relatively accurate in the Z- direction (see 'Implants and Restorative Dentistry', Chapter 11 - Imaging in oral implantology, page 178 mentioned above), in which it is described that performing measurements in the X-direction is not reliable, but performing measurements in the Z-direction is reliable. Performing measurements in the Y-dimension does not give data. The mapping may be based on a calibration element with known length and visible in the X-ray image along the Z-direction. Such fiducial markers are known to the skilled person.
In a fourth step of the method according to the invention, a 3D surface model of the jawbone at potential dental implant receptor sites 2 is created based on the soft tissue thickness information acquired during the second step of the method according to the invention, at the region of and around potential dental implant receptor sites 2.
According to one embodiment of the invention, this creating of a 3D surface model of the jawbone may be made by offsetting from the soft tissue surface, known from the digitized plaster model or the optical scan, in an inward direction, i.e. from the soft tissue surface towards the underlying bone. This offset is over distances known from statistical values provided in the second step or from the measurements performed in the second step (see Fig. 9). In the case of using the results of the measurements performed in the second step of the method, the exact offset value may be known for tissue points lying on the measurement axes, i.e. the axes determined by the hypodermic needles and their placement in the soft tissue during measurement. For the other points, i.e. points not lying on the measurement axes, but rather in between hypodermic needles, the offset value may be interpolated between known offset values in the discrete measuring points. Any suitable interpolation method can be used, e.g. polynomial interpolation. The result is a 3D surface model of the jawbone at the region of and around potential dental implant receptor sites 2 as illustrated in Fig. 10.
According to another embodiment of the invention, the thickness of the soft tissue 7 may be measured on the available X-ray image 11 in different points along the dental arch 1. These measurements may be transferred to the 3D digital representation of the intra-oral topology and may be assumed constant in a section perpendicular to the dental arch 1 , i.e. in the cross- sections or the observed values may be input into the expert system mentioned above and used to obtain adjusted values of the soft tissue thickness by extrapolating known values to values at other positions not visible on the X-ray image. According to another embodiment of the invention, the digital representation of the bone may be generated starting from the cross-section of the digital representation of the 3D stone or plaster model or of the optical scan, i.e. the intra-oral topography with soft tissue being present. By respectively offsetting the contours inwards with a constant or adjusted thickness as measured applicable in that section during the second step of the method, a set of contours is obtained defining the shape of the bone of the jaw. Using a lofting operation these contours can be used to generate a 3D representation of the bone of the jaw. With lofting operation is meant connecting two polygonal contours together with a triangular mesh, in that way producing a surface.
According to yet another embodiment of the present invention, a hollowing operation may be applied to the 3D representation of the stone or plaster model or to the optical scan that forms the 3D model of the intra-oral topography with soft tissue in place. Such a hollowing operation creates an inner surface that is uniformly offset relative to the stone or plaster model. This inner surface may be regarded as a simplified representation of the bone assuming a constant thickness of the soft tissue 7 over the entire jaw.
A fifth step of the method according to the present invention is generating a single digital project file that comprises a combination of at least the digital representation of the plaster model or the optical scan, i.e. of the intra-oral topography, the mapped X-ray image and the digital representation of the bone at the potential dental implant receptor sites 2 as obtained in the previous steps (see Fig. 11 ). This project file can be imported and used in implant planning software, for example SimPlant™, provided by Materialise, Belgium, for the purpose of simulating implant placement. In other words, the fifth step of the method according to the present invention comprises combining digital information obtained in former steps in a single digital project file to be visualised on a display, e.g. computer screen or printed on a printing device such as a plotter.
In this planning environment a digital representation of the ideal tooth set-up in the receptor sites 2 may be added, for example from a digital tooth library, to aid in the decision of where and how to place the implants 15, as illustrated in Fig. 12.
After planning, the digital representation of the intra-oral topography, e.g. plaster model or optical scan, may be used to design and produce dedicated surgical templates to assist the surgeon in transferring the implant plan to the patient during a surgical intervention.
An advantage of the present invention is that it does not require costly CT equipment and measurements, while still providing information about the bone structure. CT equipment is not always readily available so that there are dentists who do not have access to CT equipment. As CT scans submit the patient to a significant radiation loading, avoiding them is advantageous for the patient. The present invention therefore provides a safe and more easily available method for creating a personalized digital planning file for simulation of dental implant placement. Moreover, the method according to the present invention allows mapping of an X-ray image to the 3D model of the intra-oral topography in the axial direction or Z-direction, i.e. the apical-coronal direction relative to the teeth, and allows mapping by non-linear scaling and deformation of the X-ray image in the X-direction.
It is to be understood that although preferred embodiments, specific constructions and configurations, as well as materials, have been discussed herein for devices according to the present invention, various changes or modifications in form and detail may be made without departing from the scope and spirit of this invention.

Claims

1.- A method for creating a personalized digital planning environment for simulation of dental implant placement from (i) a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, (ii) an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites (2), and (iii) a two-dimensional dental X-ray image of the potential dental implant receptor sites (2), the method comprising:
- mapping the two-dimensional dental X-ray image of the potential dental implant receptor sites (2) along at least part of a dental arch (1 ) of the digitized intra-oral surface anatomy,
- constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites (2) based on the at least point- wise digital representation of soft tissue thickness, and - generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three- dimensional surface model of the bone at the potential dental implant receptor sites.
2.- Method according to claim 1 , wherein the digitized representation of an intra-oral surface anatomy is investigated for possible dental implant receptor sites (2).
3.- Method according to claim 2, wherein digitized representation of an intra- oral surface anatomy is for the entire dental arch (1 ) of the upper jaw (12) and/or lower jaw (13).
4.- Method according to any of the previous claims, wherein the digitized representation of an intra-oral surface anatomy is a surface scan of the mouth of the patient.
5.- Method according to any of claims 1 to 3, wherein the digitized representation of an intra-oral surface anatomy is obtained from an impression of the upper jaw (12) and/or lower jaw (13), whereby this impression is used to digitally capture spatial coordinates of the intra-oral surface.
6.- Method according to any of the previous claims, wherein the digital representation of the soft tissue (7) is obtained via statistical information from an expert system.
7.- Method according to any of claims 1 to 5, the soft tissue (7) having a thickness, wherein digital representation of the soft tissue (7) is obtained via local measurements of the thickness of the soft tissue.
8.- Method according to claim 7, wherein the local measurements of the thickness of the soft tissue (7) are obtained by using a depth gauge.
9.- Method according to claim 8, wherein the depth gauge comprises at least one hypodermic needle (5).
10.- Method according to claim 7, wherein local measurements of the thickness of the soft tissue (7) are obtained from ultrasound measurements.
11.- Method according to any of the previous claims, there being a curved surface following the dental arch (1 ), wherein mapping the dental X-ray image along at least part of the dental arch (1 ) is performed by folding the dental X-ray image (11 ) along the curved surface.
12.- Method according to any of the previous claims, wherein mapping the dental X-ray image along at least part of the dental arch (11 ) comprises indicating corresponding points on the dental X-ray image and on the intra-oral surface anatomy.
13.- Method according to any of the previous claims, wherein mapping the dental X-ray image along at least part of the dental arch (11 ) comprises non-uniform stretching of the X-ray image.
14.- Method according to any of the previous claims, wherein mapping the dental X-ray image along at least part of the dental arch (1 ) includes linear scaling of the X-ray image in the apical-coronal-direction of the patient.
15.- Method according to any of the previous claims, wherein mapping the dental X-ray image along at least part of the dental arch (1 ) includes nonlinear scaling of the X-ray image in the horizontal direction.
16.- Method according to any of the previous claims, wherein constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites (2) is performed by offsetting the soft tissue thickness inwardly in a direction towards the jawbone.
17.- Method according to any of the previous claims, wherein generating a single digital project file comprising information obtained in the previous steps is performed by combining obtained digital information in a single digital project visualisable on a display screen.
18.- Method according to any of the previous claims, furthermore comprising importing the digital project file into implant planning software.
19.- Computer program product for executing any of the methods as claimed in any of the previous claims when executed on a computing device associated with a simulation device for simulation of dental implant placement.
20.- Machine readable data storage device storing the computer program product of claim 19.
21.- Transmission of the computer program product of claim 19 over a local or wide area telecommunications network.
22.- A computer system for creating a personalized digital planning environment for simulation of dental implant placement from a digitised representation of an intra-oral surface anatomy of a patient including at least a part of the dental arch, an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites (2), and a two-dimensional dental X-ray image of the potential dental implant receptor sites (2), the system comprising:
- means for mapping the two-dimensional dental X-ray image of the potential dental implant receptor sites (2) along at least part of a dental arch (1 ) of the digitised intra-oral surface anatomy,
- means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites (2) based on the at least point-wise digital representation of soft tissue thickness, and - means for generating a single digital project file comprising at least the digitized representation of the intra-oral surface anatomy of the patient, the mapped two-dimensional dental X-ray image and the three-dimensional surface model of the bone at the potential dental implant receptor sites.
23.- A computer system according to claim 22, wherein the means for mapping the two-dimensional dental X-ray image comprises means for investigating for possible dental implant receptor sites (2).
24.- A computer system according to claim 22 or 23, wherein the means for mapping the two-dimensional dental X-ray image comprises means for performing a surface scan of the mouth of a patient.
25.- A computer system according to any of claims 22 to 24, wherein the means for mapping the two-dimensional dental X-ray image comprises means for performing linear scaling of the X-ray image in the apical- coronal direction of the patient.
26.- A computer system according to any of claims 22 to 25, wherein the means for mapping the two-dimensional dental X-ray image comprises means for performing non-linear scaling of the X-ray image in the horizontal direction.
27.- A computer system according to any of claims 22 to 26, the soft tissue (7) having a thickness, wherein the means for constructing a three- dimensional surface model of the bone at the potential dental implant receptor sites (2) comprises means for local measurement of the thickness of the soft tissue (7).
28.- A computer system according to any of claims 22 to 27, wherein the means for constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites (2) comprises means for performing offsetting the soft tissue thickness inwardly in a direction towards the bone.
29.- A computer system according to any of claims 22 to 28, wherein the means for generating a single digital project file comprises means for combining obtained digital information in a single digital project visualisable on a display screen.
30.- A computer system according to any of claims 22 to 29, furthermore comprising means for importing the digital project file into implant planning software.
31.- A method for creating a personalized digital planning environment for simulation of dental implant placement, the method comprising:
- digitising intra-oral surface anatomy of a patient, - generating an at least point-wise digital representation of soft tissue thickness in the region of and around potential dental implant receptor sites (2),
- taking a two-dimensional dental X-ray image of the potential dental implant receptor sites (2) and mapping it along at least part of a dental arch (1 ) of the digitised intra-oral surface anatomy,
- constructing a three-dimensional surface model of the bone at the potential dental implant receptor sites (2) based on the at least point- wise digital representation of soft tissue thickness, and
- generating a single digital project file comprising information obtained in the previous steps.
PCT/EP2007/003810 2006-05-19 2007-04-30 Method for creating a personalized digital planning file for simulation of dental implant placement WO2007134701A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2009510313A JP5561764B2 (en) 2006-05-19 2007-04-30 How to create a personal digital plan file for simulation of dental implant placement
US12/301,293 US9579170B2 (en) 2006-05-19 2007-04-30 Method for creating a personalized digital planning file for simulation of dental implant placement
EP07724737.7A EP2029047B1 (en) 2006-05-19 2007-04-30 Method for creating a personalized digital planning file for simulation of dental implant placement

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB0609988.1A GB0609988D0 (en) 2006-05-19 2006-05-19 Method for creating a personalized digital planning file for simulation of dental implant placement
GB0609988.1 2006-05-19

Publications (1)

Publication Number Publication Date
WO2007134701A1 true WO2007134701A1 (en) 2007-11-29

Family

ID=36660493

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2007/003810 WO2007134701A1 (en) 2006-05-19 2007-04-30 Method for creating a personalized digital planning file for simulation of dental implant placement

Country Status (5)

Country Link
US (1) US9579170B2 (en)
EP (1) EP2029047B1 (en)
JP (1) JP5561764B2 (en)
GB (1) GB0609988D0 (en)
WO (1) WO2007134701A1 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009027316A1 (en) * 2007-08-24 2009-03-05 2Ingis S.A. Method for making a dental prosthesis and related surgical guide
WO2009146164A1 (en) 2008-04-15 2009-12-03 Biomet 3I, Llc Method of creating an accurate bone and soft-tissue digital dental model
EP2322115A1 (en) * 2009-11-16 2011-05-18 Nobel Biocare Services AG System and method for planning and/or producing a dental prosthesis
US8038440B2 (en) 2003-02-28 2011-10-18 Materialise Dental N.V. Method for placing and manufacturing a dental superstructure, method for placing implants and accessories used thereby
US9579170B2 (en) 2006-05-19 2017-02-28 Materialise Dental N.V. Method for creating a personalized digital planning file for simulation of dental implant placement
US10456215B2 (en) 2009-11-16 2019-10-29 Nobel Biocare Services Ag System and method for planning a first and second dental restoration
BE1030844B1 (en) * 2022-09-05 2024-04-02 Millnau Method for obtaining a digitized representation of a patient's jaw

Families Citing this family (53)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2836372B1 (en) * 2002-02-28 2004-06-04 Obl METHOD AND DEVICE FOR PLACING DENTAL IMPLANTS
GB0327822D0 (en) * 2003-12-01 2003-12-31 Materialise Nv Method for manufacturing a prosthesis made prior to implant placement
SI2921131T1 (en) 2005-06-30 2021-07-30 Biomet 3I, Llc Method for manufacturing dental implant components
US8257083B2 (en) 2005-10-24 2012-09-04 Biomet 3I, Llc Methods for placing an implant analog in a physical model of the patient's mouth
US11219511B2 (en) 2005-10-24 2022-01-11 Biomet 3I, Llc Methods for placing an implant analog in a physical model of the patient's mouth
US8560047B2 (en) 2006-06-16 2013-10-15 Board Of Regents Of The University Of Nebraska Method and apparatus for computer aided surgery
US10206757B2 (en) * 2007-01-10 2019-02-19 Nobel Biocare Services Ag Method and system for dental planning and production
GB0707454D0 (en) * 2007-04-18 2007-05-23 Materialise Dental Nv Computer-assisted creation of a custom tooth set-up using facial analysis
US8206153B2 (en) 2007-05-18 2012-06-26 Biomet 3I, Inc. Method for selecting implant components
EP2060240A3 (en) 2007-11-16 2009-08-12 Biomet 3i, LLC Components for use with a surgical guide for dental implant placement
ES2739460T3 (en) * 2008-03-19 2020-01-31 Nobel Biocare Services Ag Repositioning of components related to cranial surgical procedures in a patient
WO2009146195A1 (en) 2008-04-16 2009-12-03 Biomet 3I, Llc Method for pre-operative visualization of instrumentation used with a surgical guide for dental implant placement
CN102215779A (en) * 2008-11-18 2011-10-12 Ibur有限责任公司 Dental device and method for linking physical and digital data for diagnostic, treatment planning, patient education, communication, manufacturing, and data transfer purposes
US20110045432A1 (en) * 2008-11-18 2011-02-24 Groscurth Randall C Simple linking device
US20110045431A1 (en) * 2008-11-18 2011-02-24 Groscurth Randall C Bone screw linking device
US8640338B2 (en) 2009-02-02 2014-02-04 Viax Dental Technologies, LLC Method of preparation for restoring tooth structure
US20100192375A1 (en) 2009-02-02 2010-08-05 Remedent Nv Method for producing a dentist tool
US8311791B1 (en) 2009-10-19 2012-11-13 Surgical Theater LLC Method and system for simulating surgical procedures
US9730776B2 (en) * 2010-02-24 2017-08-15 D4D Technologies, Llc Display method and system for enabling an operator to visualize and correct alignment errors in imaged data sets
GB201009999D0 (en) 2010-06-15 2010-07-21 Materialise Dental Nv Custom healing cap for dental implantology and method for design and manufacturing thereof
US10776533B2 (en) * 2010-07-12 2020-09-15 3Shape A/S 3D modeling of a dental restoration using textural features
US10299895B2 (en) 2010-09-09 2019-05-28 Hankookin, LLC Fabrication and installation of a dental implant
DK2462893T3 (en) 2010-12-07 2014-06-30 Biomet 3I Llc Universal scanning part for use on dental implant and dental implant analogs
US9788905B2 (en) 2011-03-30 2017-10-17 Surgical Theater LLC Method and system for simulating surgical procedures
ES2747818T3 (en) 2011-05-16 2020-03-11 Biomet 3I Llc Temporal abutment with combination of scanning characteristics and provisionalization characteristics
PT2739240T (en) 2011-05-26 2020-10-21 Viax Dental Tech Llc Dental tool and guidance devices
CN106913366B (en) 2011-06-27 2021-02-26 内布拉斯加大学评议会 On-tool tracking system and computer-assisted surgery method
US9498231B2 (en) 2011-06-27 2016-11-22 Board Of Regents Of The University Of Nebraska On-board tool tracking system and methods of computer assisted surgery
US11911117B2 (en) 2011-06-27 2024-02-27 Board Of Regents Of The University Of Nebraska On-board tool tracking system and methods of computer assisted surgery
GB201115265D0 (en) * 2011-09-05 2011-10-19 Materialise Dental Nv A method and system for 3d root canal treatment planning
US9089382B2 (en) 2012-01-23 2015-07-28 Biomet 3I, Llc Method and apparatus for recording spatial gingival soft tissue relationship to implant placement within alveolar bone for immediate-implant placement
US9452032B2 (en) 2012-01-23 2016-09-27 Biomet 3I, Llc Soft tissue preservation temporary (shell) immediate-implant abutment with biological active surface
IN2014DN08500A (en) 2012-05-25 2015-05-15 Surgical Theater LLC
GB201216214D0 (en) * 2012-09-12 2012-10-24 Nobel Biocare Services Ag A digital splint
GB201216224D0 (en) 2012-09-12 2012-10-24 Nobel Biocare Services Ag An improved virtual splint
US10813729B2 (en) 2012-09-14 2020-10-27 Biomet 3I, Llc Temporary dental prosthesis for use in developing final dental prosthesis
US8926328B2 (en) 2012-12-27 2015-01-06 Biomet 3I, Llc Jigs for placing dental implant analogs in models and methods of doing the same
US10105149B2 (en) 2013-03-15 2018-10-23 Board Of Regents Of The University Of Nebraska On-board tool tracking system and methods of computer assisted surgery
US20140343706A1 (en) * 2013-05-14 2014-11-20 Timothy O. Hart Customizable Healing Abutment
WO2015094700A1 (en) 2013-12-20 2015-06-25 Biomet 3I, Llc Dental system for developing custom prostheses through scanning of coded members
US9283055B2 (en) 2014-04-01 2016-03-15 FPJ Enterprises, LLC Method for establishing drill trajectory for dental implants
US11547499B2 (en) 2014-04-04 2023-01-10 Surgical Theater, Inc. Dynamic and interactive navigation in a surgical environment
US9700390B2 (en) 2014-08-22 2017-07-11 Biomet 3I, Llc Soft-tissue preservation arrangement and method
DE102014223967A1 (en) * 2014-11-25 2016-05-25 Sirona Dental Systems Gmbh Method for diagnosis in orthodontics
EP3267936A4 (en) 2015-03-09 2018-12-26 Stephen J. Chu Gingival ovate pontic and methods of using the same
WO2016153830A1 (en) * 2015-03-20 2016-09-29 3M Innovative Properties Company A method of making a dental restoration
JP6578026B2 (en) * 2015-06-09 2019-09-18 ▲シャ▼承▲キン▼SHE, Chengxin Maxillofacial surgery image calibration design system and method
ES2604122B2 (en) * 2015-09-03 2017-11-30 Leandro ARRANZ CALVO Procedure for obtaining and implanting crowns and definitive bridges over implants immediately after surgery
CN107613897B (en) 2015-10-14 2021-12-17 外科手术室公司 Augmented reality surgical navigation
EP3518813B1 (en) * 2016-09-27 2020-09-09 Dentsply Implants NV Force-closure or form-closure positioning of surgical templates for guided implant dentistry
US11007035B2 (en) 2017-03-16 2021-05-18 Viax Dental Technologies Llc System for preparing teeth for the placement of veneers
US10861236B2 (en) 2017-09-08 2020-12-08 Surgical Theater, Inc. Dual mode augmented reality surgical system and method
EP3688719A1 (en) * 2017-09-28 2020-08-05 3Shape A/S Method and system for generating a panoramic image

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5562448A (en) * 1990-04-10 1996-10-08 Mushabac; David R. Method for facilitating dental diagnosis and treatment
US6319006B1 (en) 1999-11-03 2001-11-20 Sirona Dental Systems Gmbh Method for producing a drill assistance device for a tooth implant
DE10036027A1 (en) * 2000-06-29 2002-01-10 Hans Schreiber Jaw bone morphology analysis set for dental implantation procedure has analysis device used for representation of bone cross-section replaced by drilling device for automatic preparation of implant bed
WO2004064660A2 (en) 2003-01-23 2004-08-05 Tactile Technologies Llc Dental tool guides
WO2006115841A2 (en) * 2005-04-22 2006-11-02 Align Technology, Inc. Computer aided orthodontic treatment planning

Family Cites Families (57)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH611792A5 (en) 1975-02-12 1979-06-29 Werner Lutz Koch
US4872840A (en) 1987-07-15 1989-10-10 Team Incorporated Dental implant and method
US4988297A (en) 1988-03-01 1991-01-29 Implant Innovations, Inc. Alignment corrector for dental implants
US4955811A (en) 1988-06-23 1990-09-11 Implant Innovations, Inc. Non-rotational single-tooth prosthodontic restoration
US5133660A (en) 1989-08-07 1992-07-28 Fenick Thomas J Device for locating the optimum position for a tooth implant
SE466935B (en) 1990-09-04 1992-05-04 Oscar Wilje DEVICE FOR ANCHORING OF PROSTHESIS
US5184926A (en) 1990-11-05 1993-02-09 Megatool, Inc. Root-strength drill bit and method of making
US5102271A (en) 1991-02-25 1992-04-07 Hemmings David T Collet-wear reducing drill bit
SE469159B (en) 1991-03-27 1993-05-24 Nobelpharma Ab CYLINDER INTENDED TO BE USED IN A TEMPORARY, IMPLANT DENTAL DENTAL / DENTAL PROTEIN
US5215460A (en) 1991-11-20 1993-06-01 Perry William L Method for paralleling implant restorative components
US5213502A (en) 1992-06-10 1993-05-25 Fereidoun Daftary Interlockable two-piece impression coping for anatomical dental abutment restorative systems
US5320529A (en) 1992-09-09 1994-06-14 Howard C. Weitzman Method and apparatus for locating an ideal site for a dental implant and for the precise surgical placement of that implant
US5338196A (en) 1993-04-08 1994-08-16 Implant Innovations, Inc. Dental laboratory components and procedures for anatomical restoration on artificial root fixtures
SE9301424L (en) 1993-04-28 1994-09-19 Medevelop Ab Prosthesis system for rehabilitation of toothlessness
IT1270942B (en) 1993-05-14 1997-05-26 Antonio Cascione ADJUSTABLE RADIOGRAPHIC-SURGICAL TEMPLATE FOR IMPLANTS IN THE MAXILLARY BONES.
SE501661C2 (en) 1993-08-26 1995-04-10 Nobelpharma Ab Method for imprinting and producing jawbone anchored dentures
US5662473A (en) 1993-12-02 1997-09-02 Vident Adjustable-angulation pattern for making a dental-implant abutment
US5492471A (en) 1994-03-23 1996-02-20 Gary Singer Healing cap system
US5685714A (en) 1994-06-16 1997-11-11 Implant Innovations, Inc. Support post for use in dental implant system
US5520688A (en) 1994-07-20 1996-05-28 Lin; Chih-I Vertebral auxiliary fixation device
US5613852A (en) 1995-01-06 1997-03-25 Board Of Regents Univ Of Ne At Lincoln Dental implant drill guide system
JP3621146B2 (en) * 1995-02-16 2005-02-16 東芝医用システムエンジニアリング株式会社 Diagnostic imaging equipment
IL112989A (en) 1995-03-14 1998-06-15 Avi Shampanier Implant for an artificial tooth
FR2734707B1 (en) 1995-05-30 1997-08-29 Guedj Leon DENTAL IMPLANTOLOGY SURGICAL EQUIPMENT AND ELEMENTS, DENTAL IMPLANT AND DRILLING INSTRUMENTS, COMPONENTS
US5733122A (en) 1995-05-31 1998-03-31 Gordon; Basil Dental implant attachment assembly including device and method for resisting loosening of attachment
DE69534973T2 (en) 1995-09-18 2006-09-14 Implant Innovations, Inc., Palm Beach Gardens CARRIER POST FOR A DENTAL IMPLANT SYSTEM
US6382975B1 (en) 1997-02-26 2002-05-07 Technique D'usinage Sinlab Inc. Manufacturing a dental implant drill guide and a dental implant superstructure
US5725376A (en) 1996-02-27 1998-03-10 Poirier; Michel Methods for manufacturing a dental implant drill guide and a dental implant superstructure
US6814575B2 (en) 1997-02-26 2004-11-09 Technique D'usinage Sinlab Inc. Manufacturing a dental implant drill guide and a dental implant superstructure
IL118371A (en) 1996-05-22 2000-06-29 Conley Roy Drill guide
US5823778A (en) 1996-06-14 1998-10-20 The United States Of America As Represented By The Secretary Of The Air Force Imaging method for fabricating dental devices
SE506850C2 (en) 1996-06-27 1998-02-16 Medevelop Ab Dental prosthesis systems, components for dental prosthesis systems and procedures for such dental prosthesis systems
US5769636A (en) 1996-08-16 1998-06-23 Di Sario; Francesco System for diagnosis, placement and prosthetic restoration of root form implant
BE1011205A3 (en) 1997-06-11 1999-06-01 Materialise Nv Method for the manufacture of at least one section of a new dentistry object
US7063532B1 (en) * 1997-06-20 2006-06-20 Align Technology, Inc. Subdividing a digital dentition model
US5989258A (en) 1997-09-16 1999-11-23 Hattori; Morihiro Apparatus for and method of bone drilling
US6152731A (en) * 1997-09-22 2000-11-28 3M Innovative Properties Company Methods for use in dental articulation
US6725376B1 (en) * 1997-11-13 2004-04-20 Ncr Corporation Method of using an electronic ticket and distributed server computer architecture for the same
US5967777A (en) 1997-11-24 1999-10-19 Klein; Michael Surgical template assembly and method for drilling and installing dental implants
US6514258B1 (en) 1998-11-04 2003-02-04 Implant Innovations, Inc. Penetration limiting stop elements for a drill bit used for bone tissue
EP1171054B1 (en) 1999-04-15 2007-06-06 Nobel Biocare AB Diamond-like carbon coated dental retaining screws
US6062856A (en) 1999-05-05 2000-05-16 Sussman; Harold I. Dental implant hole guide extension
IL130618A (en) * 1999-06-23 2004-01-04 Samer M Srouji Ultrasound system for use in drilling implant cavities
JP4418564B2 (en) * 1999-09-24 2010-02-17 日本特殊陶業株式会社 Artificial bone design system for compensation and method for manufacturing artificial bone for compensation using the same
US6692258B1 (en) * 2000-06-26 2004-02-17 Medical Learning Company, Inc. Patient simulator
ATE515977T1 (en) * 2000-10-11 2011-07-15 Imatx Inc METHOD AND DEVICE FOR ANALYZING X-RAY IMAGES
US6672870B2 (en) 2001-03-20 2004-01-06 John G. Knapp Method and instrumentation for attaching dentures
US7156655B2 (en) * 2001-04-13 2007-01-02 Orametrix, Inc. Method and system for comprehensive evaluation of orthodontic treatment using unified workstation
US6361537B1 (en) 2001-05-18 2002-03-26 Cinci M. Anderson Surgical plate with pawl and process for repair of a broken bone
DE10159683A1 (en) 2001-11-30 2003-06-18 Michael Gahlert Dantalimplantat
US6692254B1 (en) 2002-02-01 2004-02-17 Barry A. Kligerman Implant supported dental prosthesis foundation bar
FR2836372B1 (en) 2002-02-28 2004-06-04 Obl METHOD AND DEVICE FOR PLACING DENTAL IMPLANTS
EP2153797A3 (en) 2003-02-28 2012-01-25 Materialise Dental N.V. Method for placing and manufacturing dental superstructure and accessoires used thereby
GB0327822D0 (en) 2003-12-01 2003-12-31 Materialise Nv Method for manufacturing a prosthesis made prior to implant placement
JP3820403B2 (en) 2003-12-05 2006-09-13 株式会社アイキャット Artificial root placement position specifying device, computer program, and recording medium
EP1871274B1 (en) * 2005-03-07 2019-05-08 Align Technology, Inc. Wrinkled dental aligner
GB0609988D0 (en) 2006-05-19 2006-06-28 Materialise Nv Method for creating a personalized digital planning file for simulation of dental implant placement

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5562448A (en) * 1990-04-10 1996-10-08 Mushabac; David R. Method for facilitating dental diagnosis and treatment
US6319006B1 (en) 1999-11-03 2001-11-20 Sirona Dental Systems Gmbh Method for producing a drill assistance device for a tooth implant
DE10036027A1 (en) * 2000-06-29 2002-01-10 Hans Schreiber Jaw bone morphology analysis set for dental implantation procedure has analysis device used for representation of bone cross-section replaced by drilling device for automatic preparation of implant bed
WO2004064660A2 (en) 2003-01-23 2004-08-05 Tactile Technologies Llc Dental tool guides
WO2006115841A2 (en) * 2005-04-22 2006-11-02 Align Technology, Inc. Computer aided orthodontic treatment planning

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8038440B2 (en) 2003-02-28 2011-10-18 Materialise Dental N.V. Method for placing and manufacturing a dental superstructure, method for placing implants and accessories used thereby
US9579170B2 (en) 2006-05-19 2017-02-28 Materialise Dental N.V. Method for creating a personalized digital planning file for simulation of dental implant placement
WO2009027316A1 (en) * 2007-08-24 2009-03-05 2Ingis S.A. Method for making a dental prosthesis and related surgical guide
WO2009146164A1 (en) 2008-04-15 2009-12-03 Biomet 3I, Llc Method of creating an accurate bone and soft-tissue digital dental model
EP2276417A1 (en) * 2008-04-15 2011-01-26 Biomet 3i, LLC Method of creating an accurate bone and soft-tissue digital dental model
US9848836B2 (en) 2008-04-15 2017-12-26 Biomet 3I, Llc Method of creating an accurate bone and soft-tissue digital dental model
EP2276417A4 (en) * 2008-04-15 2015-04-08 Biomet 3I Llc Method of creating an accurate bone and soft-tissue digital dental model
JP2015165912A (en) * 2008-04-15 2015-09-24 バイオメット・３アイ・エルエルシー Method of creating accurate bone and soft-tissue digital dental model
US9204941B2 (en) 2008-04-15 2015-12-08 Biomet 3I, Llc Method of creating an accurate bone and soft-tissue digital dental model
EP2322115A1 (en) * 2009-11-16 2011-05-18 Nobel Biocare Services AG System and method for planning and/or producing a dental prosthesis
US9358082B2 (en) 2009-11-16 2016-06-07 Nobel Biocare Services Ag System and method for planning and/or producing a dental prosthesis
EP3195827A3 (en) * 2009-11-16 2017-10-11 Nobel Biocare Services AG System and method for planning and producing a dental prosthesis
WO2011057810A3 (en) * 2009-11-16 2011-07-14 Nobel Blocare Services Ag System and method for planning and/or producing a dental prosthesis
US10456215B2 (en) 2009-11-16 2019-10-29 Nobel Biocare Services Ag System and method for planning a first and second dental restoration
BE1030844B1 (en) * 2022-09-05 2024-04-02 Millnau Method for obtaining a digitized representation of a patient's jaw

Also Published As

Publication number Publication date
US9579170B2 (en) 2017-02-28
JP5561764B2 (en) 2014-07-30
US20090187393A1 (en) 2009-07-23
GB0609988D0 (en) 2006-06-28
EP2029047B1 (en) 2016-12-21
JP2009537190A (en) 2009-10-29
EP2029047A1 (en) 2009-03-04

Similar Documents

Publication Publication Date Title
EP2029047B1 (en) Method for creating a personalized digital planning file for simulation of dental implant placement
JP6099310B2 (en) Automatic dental chart creation method using digital images
US10667887B2 (en) Video-assisted margin marking for dental models
US9262864B2 (en) Synchronized views of video data and three-dimensional model data
CN1998022B (en) Method for deriving a treatment plan for orthognatic surgery and devices therefor
CN104619282B (en) Digital clamping plate
CN104619284B (en) Improved virtual clamping plate
AU2013314688B2 (en) An improved surgical template
AU2007343330B2 (en) Method and system for dental planning and production
EP2918240A1 (en) Digital dentistry
US20020010568A1 (en) Orthodontic treatment planning with user-specified simulation of tooth movement
CN104955399B (en) Generate the method and system of prosthese image
KR20160149301A (en) Identification of areas of interest during intraoral scans
US11045290B2 (en) Dynamic dental arch map
WO2008128700A1 (en) Computer-assisted creation of a custom tooth set-up using facial analysis
WO2023274690A1 (en) Non-invasive periodontal examination
CN116052890B (en) Tooth implant three-dimensional scanning modeling system and method based on Internet of things
Adindaputri et al. Accuracy of mesiodistal teeth and dental arch width measurement with conventional plaster and digital model study

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 07724737

Country of ref document: EP

Kind code of ref document: A1

DPE1 Request for preliminary examination filed after expiration of 19th month from priority date (pct application filed from 20040101)
WWE Wipo information: entry into national phase

Ref document number: 12301293

Country of ref document: US

Ref document number: 2009510313

Country of ref document: JP

NENP Non-entry into the national phase

Ref country code: DE

REEP Request for entry into the european phase

Ref document number: 2007724737

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 2007724737

Country of ref document: EP