WO2009072927A1

WO2009072927A1 - Method for producing a medical pattern based on information about the digital image of the body region

Info

Publication number: WO2009072927A1
Application number: PCT/RU2008/000723
Authority: WO
Inventors: Alexey Jurievich Remov
Original assignee: Alexey Jurievich Remov
Priority date: 2007-12-07
Filing date: 2008-11-27
Publication date: 2009-06-11
Also published as: RU2007145324A; RU2369354C2

Abstract

The inventive method for producing a medical pattern based on information about the digital image of the body region involves receiving the information about the digital image of the body region, transmitting the information about the digital image of the body region to a data processing unit in such a way that it also makes it possible to transmit to the data processing unit digital information about at least one functional element, which information can be received from external sources and also obtained inside the data processing unit. The inventive method also involves converting, with the aid of the data processing unit, the received information into a virtual pattern in such a way that it makes it possible to add thereto at least one functional element with a useful function in its capacity as a digital information function, transmitting processed data to a prototyping unit for producing a medical pattern in such a way that at least one part thereof displays data about at least several parts of said body region, wherein, for this purpose, an additional functional element with a useful function enabling to receive additional digital information about the mouth cavity is introduced into the patient's mouth cavity, which additional functional element is placed at least on such an area about which it is impossible to obtain sufficient digital information.

Description

A method of creating a medical template based on information about a digital image of a body part

Technical field

The claimed invention relates to medicine, in particular to dentistry, maxillofacial surgery. It relates to a method for creating a medical template based on information about a digital image of a body part and a future orthopedic design or without information about a future orthopedic design.

The term “medical template” means a temporarily placed positioning part on a part of the body (bone, oral mucosa, teeth, orthopedic structure, etc.) for performing a surgical operation, for example, dental implantation, in particular, for precise drilling of holes through it in the bone for the subsequent installation of implants (that is, in other words, this part, for example, indicates the direction, place and depth of drilling of the hole in the bone). There may be numerous other uses of the medical template. For example, cut off a fragment of a bone on it (according to a medical template).

The term "body part" in the text of this application refers to the part of the jaw, the entire jaw, teeth, bones, and other tissues of the body.

State of the art A known method of creating a medical template based on information about a digital image of a body part (application WO 95/28688, M. Cl. G 06 T 15/00, published 1995).

Below is the detailed information about this known method in the sequence of its operations (techniques), which exactly repeats the restrictive part of the claims with detailed comments on each operation of the method.

In accordance with the known method, information is first obtained on a digital image of a body part, for example, a jaw, in particular, made using a computed tomography scanner or any other digital image processing device, for example, a magnetic resonance imager.

Let us explain this procedure in more detail. It is practically carried out, for example, as follows: the patient comes to the X-ray room, sits in a chair or lies on the table. Then the table or chair enters the computer tomograph. The corresponding parts of the body are X-rayed and the information obtained with the help of appropriate sensors is processed in a computer into information about the digital image of the part of the body. The next operation of the known method is that the received information about the digital image of the body part is sent to the data processing unit. In addition, digital information about at least one functional element in the created medical template can be sent to the data processing unit, and digital information about this functional element can be sent either from external sources or received inside the data processing unit. A functional element is understood, for example, as a through hole in a medical template, through which, at the time of a surgical operation, drilling into bones is performed with a useful function: indicating the location and direction of drilling. The functional element may have other embodiments, for example, it may be a groove on the side of the medical template, and so on.

The subsequent operation of the known method consists in converting the received digital information using a data processing unit into a virtual model with the ability to add at least one functional element with a useful function as a digital information function (the position of the future implant in the jaw bone, the position of the drilling axis, etc.), and, as noted above, this digital information about this functional element can be sent both from external sources and can be received inside the sampler data processing.

After that, the processed data is sent to a prototyping device, which creates a medical template, at least part of which shows data on at least some parts of this part of the body.

As you know, the technology of rapid prototyping should be understood as all the technologies by which the object is built in layers or dotted with the help of filler or hardening material. This technology is also called free-form construction.

The most famous technologies of this type are:

• Stereolithography and related technologies, in which, for example, liquid synthetic material in a tank is selectively treated layer by layer using a computer-controlled electromagnetic beam;

• selective laser sintering, in which powder particles are sintered by an electromagnetic beam or connected according to a specific sample; • layer-by-layer casting with extruded melt, in which the synthetic material melts and combines in accordance with the marking.

The disadvantage of this method is that it cannot be applicable for patients with fixed prostheses, for example, bridges, crowns or stump inserts in teeth made of metal or elements of a dense structure. This is due to the fact that a metal or a dense structure element during scanning produces artifacts in a digital image (in other words, it creates such strong interference in the image that it is sometimes impossible to distinguish tissue boundaries). For this reason, under these circumstances, the method is not applicable. For its use, it is necessary to remove all fixed structures installed in the teeth and / or teeth, that is, destroy the structures that perform their function (remove crowns, bridges, stump inserts, fill the teeth, destroy everything). This circumstance greatly narrows the scope of the method.

_^ The consequence of this is that in the presence of the objects listed in the previous paragraph, which are crowns, bridges, stump tabs, etc., it is impossible to perform an operation using a medical template based on those tissues whose borders cannot be distinguished because artifacts introduced by crowns, bridges, stumps, etc.

Another disadvantage of this method is that when it is used, additional information about other teeth, orthopedic structures (crowns, bridges) that already exist in the oral cavity and do not fall into the scan area is not used. Let us explain this in more detail using an example.

If we scan the jaw of a patient in a state of closed teeth, then artifacts are possible that are introduced into digital information with of the opposite dentition and it is also not possible to isolate the occlusal surfaces of the dentition of the examined jaw (chewing surfaces) because of the contacting occlusal surfaces of the dentition of the upper and lower jaws, digital information about these surfaces merges and it is not possible to separate the occlusal surface of the dentition of the upper jaw from the occlusal surface of the dentition of the lower jaw. For this reason, usually the patient's jaws are scanned separately, that is, without closing the teeth of the upper and lower jaw. But in this case, we lose important information about the position of the teeth at the time of closure. It is necessary to select the correct implant placement and further manufacture of the orthopedic design.

The applicant considers it particularly important to draw the attention of the examination to the following: In the technical solution adopted as the closest analogue (prototype) to patent WO 95/28688 (1), a functional element with a useful function is mentioned, for example, an opening in a medical template through which at the time of surgery operations produce drilling in the bone. A functional element with a useful function is added to the data processing unit as a function of digital information and possibly a function of additional external information. In other words, the functional element in the prototype is formed either by entering information about it using some external means or it is created due to information about the digital image of the body part. However, in the known method does not provide any manipulations in the oral cavity to obtain information:

• about the relief of the oral cavity (teeth, mucous membranes, orthopedic structures) that are not distinguished in digital information obtained using a computed tomography scanner or any other digital image processing device; parts of the body due to the "eroding" effect on the digital image of metal objects present in the oral cavity,

• or information about other teeth, orthopedic structures (crowns, bridges) that already exist in the oral cavity and do not fall into the scan area. Such is the prior art of the claimed invention.

Disclosure of invention

The technical task of creating the claimed invention, after studying by the applicant of the prior art, including the above-described closest analogue (prototype), was the need to solve the following problems: Create a method that would allow:

1. Without destroying previously installed and performing their function orthopedic structures that interfere with the digital image of the body part, obtain more accurate information about the digital image of the body part (jaw, mucous membrane, teeth, orthopedic structures, etc.) with the ability to accurately highlight the boundaries of these tissues and create a medical template with a useful functional element that is exactly adjacent to the corresponding part of the body, taking into account the relief (jaw, mucous membrane, teeth, orthopedic structures and combinations of these surfaces). 2. Regardless of the interference caused by the presence of crowns, bridges, or stumps, it is possible to carry out operations without cutting and separating the mucous membrane from the bone (medical template based on teeth, mucous membranes, and orthopedic structures). 3. To increase the accuracy of drilling when installing the implant in the direction and depth and the ability to accurately transfer the planned situation in the data processing unit to the oral cavity.

The following also follows from the latter: 4. The ability to produce orthopedic structures before implant placement and fix them immediately after implant placement.

5. The ability to quickly and not costly obtain additional information about the oral cavity (which cannot be obtained in a known manner) necessary to create a medical template with a useful functional element.

6. Expanding the use of a functional element.

The particular importance of the claimed invention follows from the fact that the percentage of patients with various fixed metal structures in the oral cavity is extremely high. The stated technical problem is solved in that in the method of creating a medical template based on information about a digital image of a body part, in which

• receive information about a digital image of a body part,

• the received information about the digital image of the body part is sent to the data processing unit

• with the possibility of sending to the data processing unit also digital information about at least one functional element,

• moreover, digital information about this functional element can be sent both from external sources and can be received inside the data processing unit,

• using the data processing unit, transform the obtained information into a virtual model with the possibility of adding at least one functional element to it with a useful function as a function of digital information, • the processed data is sent to a prototyping device, which creates a medical template, at least part of which shows data on at least some parts of this body part, while, according to the claimed invention,

• an additional functional element is introduced into the patient’s oral cavity with the useful function of obtaining additional digital information about the oral cavity, which also enters the data processing unit, • the additional functional element being placed at least in an area about which it is not possible to obtain sufficient digital information .

This set of common essential features is the essence of the proposed method. It is necessary and sufficient in all cases of its implementation.

As a result of using the method, it is possible to obtain more accurate information about the digital image of a part of the body (jaw, mucous membrane, teeth, orthopedic structures) with the ability to precisely distinguish boundaries without destroying previously installed orthopedic structures that perform their function, but interfere with the digital image of the body part of these tissues and create a medical template with a useful functional element, exactly adjacent to the corresponding part of the body, taking into account the relief (jaw, mucous membrane , teeth, orthopedic structures). In addition, regardless of the interference caused by the presence of crowns, bridges, stumps, the claimed method provides the ability to perform operations without incision and separation of the mucosa from the bone (medical template based on teeth, mucous membranes and orthopedic structures). The drilling accuracy is increased when installing the implant in direction and depth and the ability to accurately transfer the planned situation in the data processing unit to the oral cavity.

It becomes possible to produce orthopedic structures before implant placement and fix them immediately after implant placement.

Provides quick and costly additional information about the oral cavity (which cannot be obtained in a known manner) necessary to create a medical template with a useful functional element.

The possibilities of using a functional element are expanding.

In addition, with regard to the method, we consider it necessary to highlight the following development and / or refinement of the general set of its essential features related to particular cases of implementation or use.

An additional functional element with the useful function of obtaining additional digital information about the oral cavity, generally speaking, can have a different embodiment in practice. Therefore, it is not disclosed in the first claim, and its various embodiments are presented in additional (functional) claims.

In particular, the additional functional element may be an element of an impression material having X-ray contrast properties, or a temporary prosthesis of X-ray contrast material, or a permanent removable prosthesis of material having the property of X-ray contrast.

Let us explain this in more detail.

As noted above, the technical result of the claimed invention is without destruction of previously installed and performing their function orthopedic structures (but interfering with a digital image of a body part), for example, metal, to obtain more accurate information about a digital image of a body part with metal objects present in the oral cavity (jaw, mucous membrane, teeth, orthopedic structures) with the ability to accurately distinguish the boundaries of these tissues and create medical template with useful functional element.

It is important to note that, generally speaking, the interference is “not absorbed” in the digital image, but, according to the invention, in the data processing unit, knowing the density thresholds of the impression material with radiopaque properties, we can distinguish the surface of this material and, accordingly, using standard techniques to highlight the boundaries fabrics that were printed in this material This operation is not disclosed in the application, since it is standard in the processing of three-dimensional images: determining a threshold (segmentation based on gray gradations), three-dimensional reduction, expansion, expansion of areas, boolean operations, such as combining and taking the difference, etc. By X-ray contrast of a material, we generally mean the possibility of a material during an X-ray examination to clearly see its borders or the borders of the tissues to which it adjoins, for example, to examine the gastrointestinal tract, the patient is given barium sulfate before X-ray examination to see if there are any changes in the gastrointestinal mucosa tract.

In relation to the claimed invention, a radiopaque material or impression material having radiopaque properties is a standard impression material used for making an impression in orthopedic dentistry, which in its chemical structure has such a degree of radiopacity, which helps to distinguish it clearly in a digital image, for example, impression materials of the following brands: manufacturer Kegg company (material: Kegr Traau), manufacturer ZM company (material: ZM-Expess Reptut), manufacturer Zhermask company (material: Zhegmask Zetarlus), etc. If the impression material has the specified property of radiopaque, then it can be used to implement the claimed method. Another important embodiment of an additional functional element is an element from the “usual” impression material (both having radiopaque properties and not having radiopaque properties), which makes it possible to obtain an accurate representation of the relief of the oral cavity as a result of the following technique: an impression of the oral cavity is taken, a model is cast on it and the resulting model is used for additional scanning with the ability to transmit digital information to the data processing unit.

Thus, in the inventive method, it is possible to use impression material that does not have radiopaque properties. It should be noted that this technique can also be used when using cast material with radiopaque properties.

When using impression material with radiopaque properties as an additional functional element, an important special case is possible when additional digital information about antagonist teeth in occlusion is obtained (normal closed position of the oral cavity). In this case, an impression of teeth is obtained in the impression material in the position of the bite, located at least in front of the area in which the implants will be installed. This makes it possible to obtain additional digital information about these teeth in the state of occlusion.

Let us explain the need for this in more detail.

It is possible to scan in the known method of the jaw in the state of occlusion, but there is no way to clearly distinguish the boundaries occlusal surfaces of the teeth (surfaces on which they chew) because of the contacting occlusal surfaces of the opposite dentition, and there is a chance of introducing “hiding” interference (artifacts) from the opposite jaw in the presence of metal objects on it. The use of an additional functional element, which is an element of cast material with radiopaque properties, with a print of teeth-antagonists makes it possible to obtain additional information about the position of the teeth of the opposite jaw (not scanned) in the state of normal closure of the jaw, even when only one jaw is scanned . This allows you to more accurately plan the operation of dental implantation, given the position of the teeth located opposite the area on which there are no teeth, that is, the area where the implants will be installed. An area about which it is not possible to obtain sufficient digital information and, at least, on which an additional functional element is laid, can represent, in particular, the mucosa, teeth, orthopedic structures, various combinations of surfaces of orthopedic structures and / or teeth and / or mucous membranes.

For the claimed method, it is also important that an additional functional element is added as a function of information about the digital image in the form in which all medical data are obvious. In this case, information from an additional functional element is processed in a data block using a computer system focused on volumetric image elements, for example, voxels.

In a method of creating a medical template based on information about a digital image of a body part, it can be used an additional operation, which consists in the introduction of solid bushings into the functional element of the medical template for precise drilling in direction and depth. Compared with the prototype, the use of solid bushings allows the milling cutter to achieve a smooth translational motion and better alignment. Carrying out the claimed method using bushings is one of the preferred private methods of carrying out the claimed method, increasing the accuracy of drilling holes in the bones for the installation of implants. The introduction of the bushings can be carried out in various ways, for example, by hammering, screwing, gluing, fusing, etc.

The bushings themselves can be made of various materials, for example, metal, ceramics. The installation of the bushings in the medical template can be carried out in various ways. However, according to the applicant, the most desirable method is that the medical template is made of plastic material, and the sleeves are made of solid material, and for installation, each sleeve is inserted by pressing into a functional element, which is, for example, a through hole, in particular a round or square shape in plan.

As the plastic material from which the medical template is made, plastic, polymer can be given.

The functional element may have other embodiments, for example, it may be a groove on the side of the medical template.

The medical template can be made not only of a plastic material, but also of a solid material, for example, metal or ceramic.

Brief Description of the Figures The invention is illustrated by figures, which depict: In FIG. 1 depicts a general flowchart of a method for creating a medical template in accordance with the invention;

In FIG. 2 schematically shows the jaw with gums and teeth at the beginning of treatment, sagital section;

In FIG. 3 - the same, in the process of setting the impression mass; In FIG. 4 - the same after closing the teeth;

In FIG. 5 schematically at the time of scanning the jaw with gum and teeth and with the impression mass in which antagonist teeth were imprinted are depicted;

In FIG. 6 depicts a separate medical template with functional elements (through holes) made according to the claimed method;

In FIG. 7 is the same, section A-A of FIG. 6; In FIG. 8 is the same, section A-A of FIG. 6 with a sleeve installed in a functional element representing a through hole;

In FIG. 9 schematically shows the jaw with gum and teeth at the time of installation of the medical template at the time of surgery.

The best embodiment of the invention

The method is illustrated by an example of a device 1 implementing the method of FIG. 1, in particular, by way of example, the treatment of a patient indicated by 2. The device 1 may have several options. One of them will be described in full below, and then some other possible options will be disclosed.

The specified device 1 includes a scanner 3 that scans the patient. As a scanner, a computer tomograph can be used. Using the scanner 3 we get the digitized image 4, containing digitized medical information. Then, the digitized image 4 is processed in the data processing unit 5. For this operation, a three-dimensional visual image 6 and / or tomographic image 7 can be used, which are formed in the usual standard way from digitized images 4 (not disclosed, since they are well known, see, for example, the closest analogue). The visual three-dimensional image 6 and the tomographic image 7 are shown in Figure 1. To maximize the use of digitized information 4, the claimed device 1 provides, along with sending to the data processing unit 5 information about the digital image of the body part, it is also possible to send digital information about at least one functional element, for example, about a hole in a virtual model, and digital information about this functional element can be sent both from external sources, to Reamer, position coordinates directed to the other device, and to receive in the data processing unit 5 (these techniques are standard and therefore not shown).

In the data processing unit 5, the obtained information is converted and a virtual model is created with the possibility of adding at least one functional element to it with a useful function as a function of digital information.

After processing the digitized image 4 in the data processing unit 5, data on the obtained virtual model is sent to the prototyping device 8, which creates a medical template 9, at least part of which clearly shows data on at least some parts of this body part. Next, the medical template is installed in the oral cavity of the patient 2 for its subsequent use for drilling through it holes in the bones installed in a well-known manner, which is not disclosed in the materials of this application, since it is not related to the object of the invention and is well known.

A distinctive common essential feature of the claimed method is that before receiving information about the digital image of the body part, an additional functional element 10 is introduced into the oral cavity of the patient 2 (see Fig. 1), with the useful function of obtaining additional digital information about the oral cavity, the additional functional element 10 is stacked at least in an area with which due to its features it is not possible to obtain sufficient digital information about it. Consider this issue in detail.

As shown in FIG. 2 the lower jaw 11 and the upper jaw 12 with the gum 13 and teeth 14 have areas from which, due to their features, it is not possible to obtain sufficient digital information. In FIG. 2 such areas are metal crowns 15 on some teeth, as well as part 16 without gum teeth 13. In the prototype, these areas do not make it possible to distinguish them without errors in the digital image of the body part (in this case, the jaw refers to the body part) , teeth of the jaw and other tissues), as a result of which the prototype cannot be used to create a model of a medical template. For this reason, crowns must be removed before applying the prototype method. To prevent this drawback, the inventive method proposes to introduce an additional functional element 10, which is often an element of impression material with radiopaque properties, before scanning into the oral cavity of patient 1. In FIG. 3, this element is made of impression material with radiopaque properties, specifically represents an radiopaque impression mass 17. Moreover, to ensure obtaining clear digital information, it is necessary that the radiopaque impression mass 17 would be stacked at least in the area from which, due to its features, it is not possible to obtain sufficient digital information about it. In this example, such an area is the area 18 of the surface of the metal crown 15 on the tooth of the lower jaw, as well as part 16 without gum teeth 13.

The radiopaque impression mass 17 has the ability to take after hardening the imprint of the shape of the object on which it was applied, and most importantly, after processing the data in the data processing unit 5, it becomes possible to obtain a clear virtual model of the object from which the impression was taken. This operation is not disclosed, since it is standard in processing three-dimensional images: determining a threshold (segmentation based on grayscale), three-dimensional reduction, expansion, expansion of areas, Boolean operations, such as combining and taking the difference, designing, etc.). The fact that it is well known follows from the prototype, where a virtual model is obtained by this technique, although the absence of an additional functional element there leads to significant interference for patients with fixed prostheses, for example, bridges, crowns or stump inserts in the teeth from metal or elements of dense structure.

After laying the impression mass 17, the patient closes the teeth (Fig. 4) and after hardening the teeth open. Imprints 19 from the antagonist teeth 20 of the upper jaw 12 remain in the impression mass (Fig. 5). The patient is sent for scanning by the scanner 3. When scanning the patient is placed between the source 21 of the x-ray radiation and the sensor 22.

The use of impression mass makes it possible not only to obtain a clear image, but also to more accurately plan the operation of dental implantation, taking into account the position of the upper teeth. This makes it possible, without scanning teeth 20, to obtain the necessary digital information and in block 5 data processing to create a virtual model of these teeth in a state of bite relationships. In FIG. 5 schematically depicts jaws with a gum and teeth and a cast mass in which antagonist teeth are imprinted. After scanning, digital information enters the data processing unit 5 (Fig. 1). In the data processing unit 5, digital information about at least one functional element with a useful function (the position of the future implant in the jaw bone, the position of the drilling axis, etc.) is attached to it, and this digital information about this functional element can be sent both from external sources, and get inside the data processing unit. After that, digital information is sent to a prototyping device 8, which makes a medical template 9 with a functional element (for example, a hole). In FIG. 6 depicts separately a medical template 9 with functional elements in the form of holes 23, made according to the claimed method. In FIG. 7 is the same, section AA of FIG. 6.

Then, solid bushings 24 are inserted into each functional element in the form of a hole 23 in the medical template 9, which perform positioning functions when drilling the bone (provide the direction of drilling in position and depth) (see Fig. 8, which shows the AA section of Fig. 6 with the installed a sleeve in the functional element representing the hole 23).

The introduction of the sleeves 24 can be carried out by driving, screwing (if there is a thread on the outer surface of the sleeve 24 and the inner surface of the hole 23), gluing, fusion, etc. The sleeve itself, in order to be solid, can be made of metal (for example, titanium, steel, etc.), ceramics, etc.

The medical template may be made of plastic solid material (in particular, plastic, polymer, etc.). Since the medical template is made of plastic material and the sleeve is solid, the sleeve is installed by pressing it into a functional element, which is a through hole, for example, round, square, etc. shapes in plan. The functional element may have other embodiments. In particular, it may be a groove on the side of the medical template 9.

At the same time, the medical template can be made of solid material, for example, plastic, metal, ceramics, etc., in this case there is no need to install the sleeve in the functional element.

After the solid sleeves 24 are embedded in the functional element 23 in the medical template 9, the medical template is sent either to the laboratory for the manufacture of the orthopedic structure or to the operating room for the operation, for example, dental implantation (implant implantation into the bone tissue of the jaw). In FIG. 9 schematically shows the jaw with gum and teeth at the time of installation of the medical template at the time of surgery.

In addition to using radiopaque impression material as an additional functional element, a temporary prosthesis of radiopaque material or a permanent removable prosthesis can be used.

An additional functional element is placed in the oral cavity on the mucosa, teeth, orthopedic structures. Moreover, in one oral cavity, various combinations of areas of orthopedic structures and / or teeth and / or mucous membranes are possible, on which an additional functional element is laid. Example, mucous membranes and teeth; teeth and orthopedic construction; just teeth; mucous membranes, teeth and orthopedic construction; etc. This is one of the variants of the claimed method. Its feature is that the patient is scanned with an additional functional element.

However, other modifications of the claimed method are possible, when an additional functional element can be introduced into the oral cavity to obtain additional digital information about the oral cavity, both before receiving digital information about the body part and after.

For example, a variant is possible whose key operation is depicted in FIG. 1 with a dashed arrow, indicated at 25, in which a mold is taken from the jaw in the oral cavity according to the standard method: the impression mass (not necessarily radiopaque) is placed in the impression spoon, inserted into the oral cavity, the spoon with the impression mass is squeezed onto the jaw with or without teeth , after hardening the impression mass, the spoon with it is removed from the oral cavity, then the model is cast according to this mold, the spoon with the impression mass is removed from the model. As a result of these actions, an exact copy of the state of the oral cavity is obtained. The model is sent to the scanner 3.

The peculiarity of this option is that the patient is scanned separately, for example, in a computed tomography scanner (to obtain a digital image of the desired area), and the above model is scanned separately, for example, in an external form scanning 3D scanner (to obtain a digital image of the model, which displays the surface of the studied area without distortion from the influence of interference caused by metal objects). This makes it possible to combine this data in the data processing unit 5 and to exclude artifacts on the virtual model caused by metal objects obtained by scanning the patient in a computer tomograph. As you can see, the essence of the method has remained the same (to obtain information about the digital image of the body part, an additional functional element is introduced into the patient’s oral cavity with the useful function of obtaining additional digital information about the oral cavity, the additional functional element being placed at least in the area which due to its features it is not possible to obtain sufficient digital information about it), and the difference is that the patient is scanned without an additional functional element, the relief of which is scanned separate. The above illustrates a modification of the claimed method, according to which the additional functional element is an element of impression material, at least not having radiopaque properties, and, when using it, an oral impression is taken, a model is cast on it and the resulting model is used for additional scanning with the ability to transmit digital information to the data processing unit (paragraph 5 of the claims).

Note: the expression "an element of impression material, at least not having radiopaque properties," means that it can be used independently as an element of impression material that does not have radiopaque properties, or independently an element of impression material with radiopaque properties.

In addition, a modification of the claimed method is possible, according to which when using impression material with radiopaque properties as an additional functional element, an impression of teeth is obtained in the impression material in the position of the bite, located at least opposite to the area in which the implants will be installed. The peculiarity of this option is that when using impression material with radiopaque properties as an additional functional element, a patient with an open mouth is scanned, for example, in a computer tomograph (to obtain a digital image of the desired area). In this case, one jaw can be scanned, and the necessary digital information about the surface of the teeth of the unscanned jaw can be obtained, and in the position of normal closing of the teeth. This makes it possible to exclude possible artifacts in the digital image caused by metal objects if you expand the patient’s scanning area in a computer tomograph (if together the upper and lower jaw in the position of closed teeth), and, importantly, take into account the position of the teeth in the bite, located at least opposite to the area in which th implants will be installed. As a result, in the inventive method, in connection with obtaining an impression of the antagonist teeth in the bite, it becomes possible to more correctly install implants taking into account the axes of the loads from the antagonist teeth.

The invention is illustrated by a clinical example.

Patient K., 80 years old, complained of mobility and soreness of the teeth in the lower jaw.

Diagnosis: partial adentia on the lower jaw. A removable denture is fixed on the remaining 33.43 teeth.

On examination, it was revealed that the remaining fangs on the lower jaw have a third degree of mobility with an inflammatory focus around them. It is necessary to remove the two remaining teeth, while the prosthesis that fixes to them loses its functionality.

The patient, due to his active social activities, cannot remain without a denture in the oral cavity.

The decision was made to simultaneously remove the teeth and install two implants and fix the prosthesis to them. At the time of surgery teeth are removed, an incision is made, two implants are installed. After removing the sutures, poor healing of the mucous membrane, diabetes mellitus in the accompanying pathology. As a result, after 1.5 months the mobility of one implant appears and we are forced to remove it. The remaining one implant will not withstand the load of the prosthesis fixed to it for a long time.

It was decided to use the technology described above. For this: a cast was taken from the lower jaw and before a CT scan it was introduced into the oral cavity as an additional functional element ..

After processing the digital image of the body part with an additional functional element in the data processing unit.

Using the described technology, we planned the installation of implants and made a medical positioning template. They performed an operation without an incision and installed 4 implants and immediately fixed the prosthesis to the installed new implants.

The operation lasted 15 minutes, and the previous 1 hour. She was successful. There was no edema and severe pain after the operation, because the implants were inserted without separating the mucous membrane and periosteum from the bone.

This observation illustrates the complex case to which the claimed invention was applied.

Industrial applicability

The invention is intended for use in medical institutions. The use of the claimed invention can significantly improve the results of surgical treatment.

Reducing the time of the operation, its low invasiveness and precise positioning of the implants, planning are significant advantages of the claimed invention.

In addition, the use of the claimed invention can significantly expand the possibilities of providing high-tech care to patients who also have fixed prostheses, for example, bridges, crowns or stump inserts in teeth made of metal or elements of a dense structure, without destroying previously installed and performing their function orthopedic structures that create interference, to obtain accurate information about the digital image of a part of the body (jaw, mucous membrane, teeth, orthopedic structures) with the ability internally to allocate the border of these tissues and obtain a virtual model of a useful functional element, as well as create a medical template, just adjacent to the corresponding part of the body because of its topography (jaw, mucosa, teeth, prosthetics) with useful functional element.

When applying the claimed invention, a traumatic ™ operation is reduced, since in the presence of interference caused by crowns, bridges, stumps, it is possible to perform operations without cutting and separating the mucous membrane from the bone (medical template based on teeth, mucous membranes and orthopedic structures). The invention improves the accuracy of drilling when installing the implant in direction and depth and the ability to accurately transmit the planned situation in the data processing unit to the oral cavity.

This implies: • The ability to produce orthopedic structures before implant placement and fix them immediately after implant placement;

• The ability to quickly and not costly obtain additional information about the oral cavity (which cannot be obtained in a known manner) necessary to create a virtual model with a useful functional element. In addition to the above variants of the invention, numerous other modifications thereof are possible. All of them are covered by the following claims.

Claims

Claim

1. A method of creating a medical template based on information about a digital image of a body part, in which information about a digital image of a body part is obtained, information obtained about a digital image of a body part is sent to a data processing unit with the possibility of sending also digital information about at least one functional element, and digital information about this functional element can be sent either from external sources or received inside the data processing unit, I transform using the data processing unit, the received information in a virtual model with the ability to add at least one functional element with a useful function as a digital information function, the processed data is sent to a prototyping device, which creates a medical template, at least part which shows data on at least some parts of this part of the body, characterized in that an additional functional element with a useful function of obtaining additional actual digital information about the oral cavity, which also enters the data processing unit, the additional functional element being laid at least in an area about which it is not possible to obtain sufficient digital information.

2. The method according to p. 1, characterized in that the additional functional element is an element of cast material with radiopaque properties.

3. The method according to p. 1, characterized in that the additional functional element is a temporary prosthesis made of radiopaque material.

4. The method according to p. 1, characterized in that the additional functional element is a permanent removable prosthesis made of a material having the property of X-ray growth.

5. The method according to p. 1, characterized in that the additional functional element is an element of cast material, at least not possessing radiopaque properties, moreover, when using it, an impression of the oral cavity is taken, a model is cast on it, and the obtained model is used for additional scanning with the ability to transmit digital information to the data processing unit.

6. The method according to p. 1, characterized in that when used as an additional functional element of the impression material having radiopaque properties, an impression of teeth is obtained in the impression material in the position of the bite, located at least opposite the area in which the implants will be installed .

7. The method according to p. 1, characterized in that the region on which the additional functional element is laid is a mucous membrane.

8. The method according to p. 1, characterized in that the region on which the additional functional element is laid is teeth.

9. The method according to p. 1, characterized in that the region on which the additional functional element is laid is orthopedic construction.

10. The method according to p. 1, characterized in that the area on which the additional functional element is laid is a different combination of surfaces of orthopedic structures and / or teeth and / or mucous membranes.

11. The method according to p. 1, characterized in that the additional functional element is added as a function of information about the digital image in the form in which all medical data are obvious.

12. The method according to p. 1, characterized in that the information from the additional functional element is actually processed in the data block using a computer system focused on volumetric image elements.

13. The method according to p. 1, characterized in that the sleeve of solid material is introduced into the functional element of the medical template.

14. The method according to p. 13, characterized in that the bushings are introduced by pumping.

15. The method according to item 13, wherein the bushings are introduced by screwing.

16. The method according to p. 13, characterized in that the bushings are introduced by gluing.

17. The method according to item 13, wherein the bushings are introduced by fusion.

18. The method according to item 13, wherein the bushings are made of metal.

19. The method according to item 13, wherein the bushings are made of ceramic.

20. The method according to item 13, wherein the medical template is made of plastic material, and for installation, the sleeve is introduced by pressing in a functional element.

21. The method according to claim 20, characterized in that the functional element is a through hole.

22. The method according to claim 20, characterized in that the through hole has a circular shape in plan.

23. The method according to claim 20, characterized in that the through hole has a square shape in plan.

24. The method according to claim 20, characterized in that the functional element is a groove on the side of the medical template.

25. The method according to item 13, wherein the medical template is made of solid material.

26. The method according A.25, characterized in that as a solid material using metal.

27. The method according A.25, characterized in that as a solid material using ceramics.