WO2013038035A1 - Method for quality control of dental prosthetic structures which can be used over implants - Google Patents

Method for quality control of dental prosthetic structures which can be used over implants Download PDF

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Publication number
WO2013038035A1
WO2013038035A1 PCT/ES2012/000240 ES2012000240W WO2013038035A1 WO 2013038035 A1 WO2013038035 A1 WO 2013038035A1 ES 2012000240 W ES2012000240 W ES 2012000240W WO 2013038035 A1 WO2013038035 A1 WO 2013038035A1
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WIPO (PCT)
Prior art keywords
posts
implants
mouth
computer
patient
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PCT/ES2012/000240
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Spanish (es)
French (fr)
Inventor
Josep Soler Cegarra
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Josep Soler Cegarra
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Publication of WO2013038035A1 publication Critical patent/WO2013038035A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; 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
    • 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
    • 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 a method for quality control of dental prosthetic structures applicable on implants. Field of application of the invention.
  • This invention is applicable in the dental prostheses manufacturing sector, and more specifically in the elaboration of attachable dental prostheses on artificial implants in the jaw and maxilla. Background of the invention.
  • Prosthetics and dentists usually use a method based on screwing the structure to the model or mouth, connection by connection with a single screw, and checking if the structure moves from its original position. If it moves, they consider the structure to be wrong because it has no passivity.
  • a structure whose connections coincide fairly closely with the arrangement of the implants can vary the compliance of their coupling simply by the order of screwing in said implants.
  • a structure that presents a connection outside of tolerance it can be difficult to place if the fixing is initiated by said uneven connection or coupled in an acceptable way if this connection is the last one fixed.
  • the Spanish patent application P201130217 is known for "Method for the design of implant denture structures" which describes a method comprising modeling the positions of the implants placed in the patient's mouth for the calculation of the milling program of the structure of the prosthesis, attachable on said implants.
  • Said implant modeling comprises the steps of placing posts, detectable by X-rays, on the implants in the patient's mouth; performing a CT scan of the patient's mouth with the posts; the conversion of the TAC result to a three-dimensional computer model for CAD / CAM manipulation; the definition of the posts in the computer model; CAD / CAM modeling of the structure on the computer model with the defined posts; the generation of a file of positions and orientations for the calculation of the milling program of structures.
  • This method has the advantage that the entire process that is originally performed with molds and physical samples molded in silicone and plaster is done by computer. However, it requires a CT scan of the person to obtain the starting data, which is not desired by many doctors, who prefer not to radiate the patient unnecessarily if there is an alternative method.
  • the method for the quality control of dental prosthetic structures applicable on implants presents some technical peculiarities intended to determine whether a prosthetic structure has its connections within a tolerance range for mounting on implants of the mouth of the patient without causing tensions or minimizing them, in the fixation bones.
  • the invention allows to obtain the order of fixing the connections of the structure to the implants so that the prosthetic structure fits in the most correct way possible.
  • the method is applicable to the design of structures of the type designed to be mounted on implants in the patient's mouth; said structure having been made from a physical model of disposition of the implants in the patient's mouth, this physical model being obtained by printing and molding technique or by the patent system mentioned in the background.
  • a computer modeling of the positions of the implants placed in the patient's mouth has been carried out preferably for the calculation of the milling program of the structure of the prosthesis.
  • the computer modeling of the structure is obtained through the use of a CT (computerized axial tomography),
  • the method comprises:

Abstract

The method, applicable to the design of structures mounted over implants in the patient's mouth, comprises: - the attachment of posts to the connections of the structure with the implants; - production of a CAT of the structure; definition on the CAT of the posts with respect to the structure; - conversion of the definition data to a computer model; - achieving the best individual adjustment of the posts in the stereolithograph computer model; - extraction of a computer model providing access to information on positions and orientations of the posts; - comparison of the information with the information acquired in the CAT of the actual plaster, mouth or silicone for taking the impression; - positioning of the coincidence between the two computer models, by mutual assembly at a concrete connection, checking the differences in terms of spatial distance and whether they are tolerable; - repetition of the positioning of the coincidences for each one of the structure connections.

Description

DESCRIPCIÓN  DESCRIPTION
MÉTODO PARA EL CONTROL DE CALIDAD DE ESTRUCTURAS PROTÉSICAS DENTALES APLICABLES SOBRE IMPLANTES. Objeto de la invención  METHOD FOR QUALITY CONTROL OF APPLICABLE DENTAL PROSTHETIC STRUCTURES ON IMPLANTS. Object of the invention
La presente invención se refiere a un método para el control de calidad de estructuras protésicas dentales aplicables sobre implantes. Campo de aplicación de la invención. The present invention relates to a method for quality control of dental prosthetic structures applicable on implants. Field of application of the invention.
Esta invención es aplicable en el sector de la elaboración de prótesis dentales, y más concretamente en la elaboración de prótesis dentales acoplables sobre implantes artificiales en mandíbula y maxilar. Antecedentes de la invención.  This invention is applicable in the dental prostheses manufacturing sector, and more specifically in the elaboration of attachable dental prostheses on artificial implants in the jaw and maxilla. Background of the invention.
El control de calidad del ajuste de las estructuras (barras, puentes, híbridas, etc..) fresadas, sinterizadas, etc.. atornilladas directamente sobre implantes, hasta hoy es completamente subjetivo.  The quality control of the adjustment of the structures (bars, bridges, hybrids, etc.) milled, sintered, etc ... screwed directly onto implants, until today is completely subjective.
Los protésicos y dentistas habitualmente usan un método basado en atornillar la estructura al modelo o bien a boca, conexión por conexión con un único tornillo, y comprobar si la estructura se desplaza de su posición original. Si se desplaza consideran que la estructura es errónea porque no tiene pasividad.  Prosthetics and dentists usually use a method based on screwing the structure to the model or mouth, connection by connection with a single screw, and checking if the structure moves from its original position. If it moves, they consider the structure to be wrong because it has no passivity.
Esta situación es debida principalmente a que en el proceso de elaboración de la estructura se van acumulando errores y desviaciones desde el mismo momento de la toma de impresión de la boca del paciente y la elaboración de los distintos modelos físicos de escayola con los que se elaborará dicha estructura.  This situation is mainly due to the fact that in the process of elaboration of the structure errors and deviations are accumulating from the moment of the impression of the patient's mouth and the elaboration of the different physical models of plaster with which it will be elaborated said structure.
Estos errores y desviaciones de montaje entre las conexiones de la estructura y los implantes en la boca del paciente conllevan a tensiones en el hueso que como mínimo son incómodas, y pueden llegar a generar lesiones y dolor al paciente.  These errors and assembly deviations between the connections of the structure and the implants in the patient's mouth lead to tensions in the bone that are at least uncomfortable, and can lead to injury and pain to the patient.
Además, una estructura cuyas conexiones coincidan de forma bastante aproximada con la disposición de los implantes puede variar la conformidad de su acoplamiento simplemente por el orden de atornillado en dichos implantes. Así, en el caso de una estructura que presenta una conexión fuera de la tolerancia puede ser difícilmente colocable si se inicia la fijación por dicha conexión dispar o acoplarse de forma aceptable si esta conexión es la última que se fija. In addition, a structure whose connections coincide fairly closely with the arrangement of the implants can vary the compliance of their coupling simply by the order of screwing in said implants. Thus, in the case of a structure that presents a connection outside of tolerance it can be difficult to place if the fixing is initiated by said uneven connection or coupled in an acceptable way if this connection is the last one fixed.
Es conocida la solicitud de patente española P201130217 por "Método para el diseño de estructuras de prótesis dentales sobre implantes" que describe un método que comprende la modelización de las posiciones de los implantes colocados en la boca del paciente para el cálculo del programa de fresado de la estructura de la prótesis, acoplable sobre dichos implantes. Dicha modelización de los implantes comprende las etapas de colocación de unos postes, detectables por rayos X, sobre los implantes en la boca del paciente; la realización de un TAC de la boca del paciente con los postes; la conversión del resultado del TAC a un modelo informático en tres dimensiones para su manipulación CAD/CAM; la definición de los postes en el modelo informático; el modelado CAD/CAM de la estructura sobre el modelo informático con los postes definidos; la generación de un archivo de posiciones y orientaciones para el cálculo del programa de fresado de estructuras.  The Spanish patent application P201130217 is known for "Method for the design of implant denture structures" which describes a method comprising modeling the positions of the implants placed in the patient's mouth for the calculation of the milling program of the structure of the prosthesis, attachable on said implants. Said implant modeling comprises the steps of placing posts, detectable by X-rays, on the implants in the patient's mouth; performing a CT scan of the patient's mouth with the posts; the conversion of the TAC result to a three-dimensional computer model for CAD / CAM manipulation; the definition of the posts in the computer model; CAD / CAM modeling of the structure on the computer model with the defined posts; the generation of a file of positions and orientations for the calculation of the milling program of structures.
Este método presenta la ventaja de que todo el proceso que originalmente se realiza con moldes y muestras físicas moldeadas en silicona y escayola se realiza por ordenador. Sin embargo requiere que se realice un TAC de la persona para obtener los datos de partida, lo cual no es deseado por muchos médicos, que prefieren no irradiar al paciente de forma innecesaria si existe un método alternativo.  This method has the advantage that the entire process that is originally performed with molds and physical samples molded in silicone and plaster is done by computer. However, it requires a CT scan of the person to obtain the starting data, which is not desired by many doctors, who prefer not to radiate the patient unnecessarily if there is an alternative method.
Descripción de la invención Description of the invention
El método para el control de calidad de estructuras protésicas dentales aplicables sobre implantes, objeto de esta invención, presenta unas particularidades técnicas destinadas a determinar si una estructura protésica presenta sus conexiones dentro de un margen de tolerancia para su montaje sobre los implantes de la boca del paciente sin causar tensiones o minimizándolas, en los huesos de fijación. Además la invención permite obtener el orden de fijación de las conexiones de la estructura a los implantes para que la estructura protésica se acople de la forma más correcta posible.  The method for the quality control of dental prosthetic structures applicable on implants, object of this invention, presents some technical peculiarities intended to determine whether a prosthetic structure has its connections within a tolerance range for mounting on implants of the mouth of the patient without causing tensions or minimizing them, in the fixation bones. In addition, the invention allows to obtain the order of fixing the connections of the structure to the implants so that the prosthetic structure fits in the most correct way possible.
El método es aplicable al diseño de estructuras del tipo de las destinadas a montarse sobre implantes en la boca del paciente; habiéndose realizado dicha estructura a partir de un modelo físico de disposición de los implantes en la boca del paciente, estando este modelo físico obtenido por técnica de impresión y moldeado o bien mediante el sistema de la patente mencionada en los antecedentes. En la obtención de esta estructura se ha llevado a cabo, preferentemente, una modelización informática de las posiciones de los implantes colocados en la boca del paciente para el cálculo del programa de fresado de la estructura de la prótesis. La modelización informática de la estructura se obtiene mediante el uso de un TAC (tomografía axial computerizada), The method is applicable to the design of structures of the type designed to be mounted on implants in the patient's mouth; said structure having been made from a physical model of disposition of the implants in the patient's mouth, this physical model being obtained by printing and molding technique or by the patent system mentioned in the background. In the In order to obtain this structure, a computer modeling of the positions of the implants placed in the patient's mouth has been carried out preferably for the calculation of the milling program of the structure of the prosthesis. The computer modeling of the structure is obtained through the use of a CT (computerized axial tomography),
De acuerdo con la invención, el método comprende:  According to the invention, the method comprises:
a) la fijación de unos postes a las conexiones de la estructura con los implantes, b) realización de un TAC de la estructura con los postes fijados en la zona de ajuste de las conexiones de la estructura con los implantes, a) the fixing of posts to the connections of the structure with the implants, b) realization of a TAC of the structure with the posts fixed in the area of adjustment of the connections of the structure with the implants,
c) definición en el TAC de los postes respecto al resto de la estructura mediante un sistema informático, c) definition in the TAC of the posts with respect to the rest of the structure by means of a computer system,
d) conversión de los datos de la definición de los postes en el TAC a un modelo informático de estereolitografía (STL), d) conversion of the data of the definition of the posts in the TAC to a computer model of stereolithography (STL),
e) realización del mejor ajuste del modelo CAD de los postes en cada una de las imágenes de los postes adquiridos en el modelo informático de estereolitografía, f) extracción de un modelo informático (CAD, numérico, etc,...) en donde sea accesible la información de posiciones y orientaciones de los postes. e) realization of the best adjustment of the CAD model of the posts in each of the images of the posts acquired in the stereolithography computer model, f) extraction of a computer model (CAD, numeric, etc, ...) wherever accessible information about positions and orientations of the posts.
g) comparación de la información, mediante sistema informático con la información adquirida en el TAC de la propia escayola, boca o silicona de la toma de impresión, g) comparison of the information, by computer system with the information acquired in the TAC of the plaster itself, mouth or silicone of the impression,
h) posicionamiento de la coincidencia de los dos modelos informáticos, mediante una simulación CAD de ajuste del modelo informático de estereolitografía con el modelo informático de la estructura, mediante ensamblaje de uno con otro en una conexión concreta, comprobando las diferencias en distancia espacial y comprobando si estas diferencias se encuentran o no en e umbral de tolerancia admitida, h) positioning of the coincidence of the two computer models, by means of a CAD simulation of adjustment of the stereolithography computer model with the computer model of the structure, by assembling one with another in a specific connection, checking the differences in spatial distance and checking Whether or not these differences are within the tolerance threshold allowed,
i) repetición del posicionamiento de las coincidencias de los dos modelos informáticos para cada una de las conexiones de la estructura, determinando el orden óptimo de atornillado de la estructura para que los implantes en boca se vean sometidos a la mínima tensión resultante del atornillado de la estructura. i) repetition of the positioning of the coincidences of the two computer models for each of the connections of the structure, determining the optimal order of screwing the structure so that the implants in the mouth are subjected to the minimum tension resulting from the screwing of the structure.
Con este método se puede comparar el resultado físico de la estructura obtenida, con los datos iniciales de desarrollo obtenidos en la muestra de impresión o TAC de boca. Así se asegura que dicha estructura entra dentro de unos parámetros de calidad que proporcionan un ajuste efectivo en el momento del acoplamiento de esta estructura protésica sobre los implantes en la boca del paciente. With this method you can compare the physical result of the structure obtained, with the initial development data obtained in the print sample or mouth CT. This ensures that said structure falls within parameters of quality that provide an effective fit at the time of the coupling of this prosthetic structure on the implants in the patient's mouth.
Esta comparación se hace mediante los respectivos modelos informáticos utilizando simulaciones por ordenador, pudiéndose probar el mejor acoplamiento posible sin tener que trabajar sobre el paciente. Con este método, se reducen los problemas de colocación de la estructura protésica en los implantes de la boca del paciente y las tensiones introducidas en la estructura ósea.  This comparison is made using the respective computer models using computer simulations, being able to test the best possible coupling without having to work on the patient. With this method, the problems of placing the prosthetic structure in the implants of the patient's mouth and the stresses introduced in the bone structure are reduced.
Mediante este método se demuestra que una estructura fabricada, puede parecer errónea cuando se atornilla dicha estructura en un orden inadecuado de conexiones.  This method demonstrates that a manufactured structure may appear to be wrong when the structure is screwed in an inappropriate order of connections.
Cabe destacar que por muy correcta que sea una estructura, hay que considerar que siempre tiene un umbral de tolerancia y más cuando se trata de ajustar varios puntos de apoyo. El posicionamiento resultante en cada una de las conexiones se garantiza una distribución de las posibles tensiones minimizando de esta forma los posibles daños que pudiese ocasionar en la estructura ósea en que se soportan los implantes. Si el umbral de tolerancia admitido (en un ejemplo 0,05 milímetros es suficiente) es correcto las tensiones en hueso son insignificantes al seguir el orden de apriete que da a conocer el método de la invención.  It should be noted that no matter how correct a structure is, it must be considered that it always has a tolerance threshold and more when it comes to adjusting several support points. The resulting positioning in each of the connections guarantees a distribution of the possible tensions minimizing in this way the possible damages that could cause in the bone structure in which the implants are supported. If the tolerance threshold admitted (in an example 0.05 millimeters is sufficient) is correct, the tensions in bone are insignificant by following the tightening order of the method of the invention.

Claims

REIVINDICACIONES
1.- Método para el control de calidad de estructuras protésicas dentales; siendo dichas estructuras del tipo de las destinadas a montarse sobre implantes en la boca del paciente; habiéndose realizado dicha estructura a partir de un modelo físico de los implantes en la boca del paciente, obtenido por técnica de impresión y moldeado o mediante TAC de la boca del paciente, y la modelización informática de las posiciones de los implantes colocados en la boca del paciente para el cálculo del programa de fresado de la estructura de la prótesis, realizándose esta modelización informática por un TAC (tomografía axial computerizada), caracterizado porque comprende: 1.- Method for quality control of dental prosthetic structures; said structures being of the type intended to be mounted on implants in the patient's mouth; said structure having been made from a physical model of the implants in the patient's mouth, obtained by printing and molding technique or by CT of the patient's mouth, and computer modeling of the positions of the implants placed in the mouth of the patient. patient for the calculation of the milling program of the structure of the prosthesis, this computer modeling being performed by a CT (computerized axial tomography), characterized in that it comprises:
a) la fijación de unos postes a las conexiones de la estructura con los implantes, b) realización de un TAC de la estructura con los postes fijados en la zona de ajuste de las conexiones de la estructura con los implantes,  a) the fixing of posts to the connections of the structure with the implants, b) realization of a TAC of the structure with the posts fixed in the area of adjustment of the connections of the structure with the implants,
c) definición en el TAC de los postes respecto al resto de la estructura mediante un sistema informático,  c) definition in the TAC of the posts with respect to the rest of the structure by means of a computer system,
d) conversión de los datos de la definición de los postes en el TAC a un modelo informático de estereolitografía (STL),  d) conversion of the data of the definition of the posts in the TAC to a computer model of stereolithography (STL),
e) realización del mejor ajuste del modelo CAD de los postes en cada una de las imágenes de los postes adquiridos en el modelo informático de estereolitografía,  e) realization of the best adjustment of the CAD model of the posts in each of the images of the posts acquired in the stereolithography computer model,
f) extracción de un modelo informático (CAD, numérico, u otro) en donde sea accesible la información de posiciones y orientaciones de los postes, g) comparación de la información, mediante sistema informático con la información adquirida en el TAC de la propia escayola, boca o silicona de la toma de impresión,  f) extraction of a computer model (CAD, numerical, or other) where the information of positions and orientations of the posts is accessible, g) comparison of the information, by means of a computer system with the information acquired in the TAC of the plaster itself , mouth or silicone of the impression,
h) posicionamiento de la coincidencia de los dos modelos informáticos, mediante una simulación CAD de ajuste del modelo informático de estereolitografía con el modelo informático de la estructura, mediante ensamblaje de uno con otro en una conexión concreta, comprobando las diferencias en distancia espacial y comprobando si estas diferencias se encuentran o no en e umbral de tolerancia admitida,  h) positioning of the coincidence of the two computer models, by means of a CAD simulation of adjustment of the stereolithography computer model with the computer model of the structure, by assembling one with another in a specific connection, checking the differences in spatial distance and checking Whether or not these differences are within the tolerance threshold allowed,
i) repetición del posicionamiento de las coincidencias de los dos modelos informáticos para cada una de las conexiones de la estructura, determinando el orden óptimo de atornillado de la estructura para que los implantes en boca se vean sometidos a la mínima tensión resultante del atornillado de la estructura. i) repetition of the positioning of the coincidences of the two computer models for each of the connections of the structure, determining the optimal order of screwing the structure so that the implants in the mouth are subjected to the minimum tension resulting from the screwing of the structure.
PCT/ES2012/000240 2011-09-14 2012-09-14 Method for quality control of dental prosthetic structures which can be used over implants WO2013038035A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ES201131493A ES2372953B1 (en) 2011-09-14 2011-09-14 METHOD FOR QUALITY CONTROL OF APPLICABLE DENTAL PROSTHETIC STRUCTURES ON IMPLANTS.
ESP201131493 2011-09-14

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050070782A1 (en) * 2003-07-17 2005-03-31 Dmitri Brodkin Digital technologies for planning and carrying out dental restorative procedures
US20110136080A1 (en) * 2008-01-25 2011-06-09 Stephan Holzner Method for modeling an individual dental prosthesis
ES2364393A1 (en) * 2011-02-21 2011-09-01 Josep Soler Cegarra Method for designing dental prosthesis structures on implants

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050070782A1 (en) * 2003-07-17 2005-03-31 Dmitri Brodkin Digital technologies for planning and carrying out dental restorative procedures
US20110136080A1 (en) * 2008-01-25 2011-06-09 Stephan Holzner Method for modeling an individual dental prosthesis
ES2364393A1 (en) * 2011-02-21 2011-09-01 Josep Soler Cegarra Method for designing dental prosthesis structures on implants

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ES2372953B1 (en) 2012-12-04

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