CN109199614B - Jaw bone positioning and fixing device for navigation positioning and mandible fixing in robot dental implant operation process - Google Patents

Abstract

The utility model provides a jawbone location fixing device for navigation location and mandible are fixed in the operation of robot implant, skull support both sides are connected with oral cavity mouth gag through two flexible mechanical devices that are connected with rotation-flexible mechanical device as the center, the tongue baffle is connected in oral cavity mouth gag lower extreme both sides, mandibular tray both ends link to each other with oral cavity mouth gag through another flexible mechanical device respectively, the orientation is moved the locator and is installed on the flexible mechanical device that the skull support both sides link to each other, the operation location marker for image navigation is fixed on orientation and is moved locator symmetry central line, the opening angle department of oral cavity mouth gag rotation-flexible mechanical device and all flexible mechanical device are last to install the calibrated scale. The invention avoids interference generated during robotic surgery and can improve the precision of the preparation link of the implantation surgery cavity, the safety of the implantation surgery and the navigation positioning precision of the surgery.

Description

Jawbone for navigation, positioning and mandibular fixation during robotic dental implant surgery Positioning fixtures

Technical field

The invention relates to the field of oral and maxillofacial surgical medical instruments, and in particular to a jaw positioning and fixing device used for navigation, positioning and mandibular fixation during robotic dental implant surgery.

Background technique

After tooth loss, the current preferred method of restoration is artificial dental implant restoration, which means artificial dental implants are surgically implanted in the jaw and connected to abutments and crowns to restore the patient's chewing, appearance and other functions. In traditional dental implant surgery, during the process of cavity preparation and implant screwing, medical staff mainly rely on the bare hands to fix the patient's head and jaw, and hold the implant handpiece to perform cavity preparation and other surgical operations; with the research and development of robotic surgical systems, With the development of dental implant technology, robotic dental implant technology has begun to be applied clinically. Using the robotic dental implant system, the patient wears a positioning marker in the oral cavity before surgery and takes CT/CBCT data, and then plans the implant plan. During the operation, the robot achieves precise positioning through the positioning marker, and the robot system uses visual navigation under the supervision of the doctor. Complete cavity preparation and other operations independently. Robotic dental implant technology can significantly improve the automation and accuracy of dental implant operations. It is an important development direction in the field of oral implants at present and has good application scenarios.

The biggest problem with using a robotic system to perform dental implant surgery on the mandible is that the mandible is a movable bone. If you hold the patient's mandible with your hands for fixation and positioning during the operation, it will easily interfere with the robot. At the same time, due to the axial drilling force, Under the action, it is difficult to ensure the stability of the mandible with bare hands, resulting in deviations, which seriously affects the accuracy of robotic dental implant operations. Currently, in robotic dental implant systems, positioning markers fixed in the patient's mouth are generally used to capture and determine the real-time position of the mandible using infrared, machine vision, or electromagnetic positioning methods. However, the response speed of these positioning methods is slow. , it is easy to cause lags due to the large amount of calculations caused by real-time collection of images. At the same time, there is room for improvement in the accuracy of these positioning methods. On the one hand, since the surgical positioning marker is fixed in the surgical area of the patient's mouth, it will affect the operating space of the robot system and easily cause interference. On the other hand, for full/half-mouth edentulous patients, the surgical positioning marker must be installed before surgery. There is bound to be a positional deviation when taking the CT and during the second placement during the operation, which also affects the accuracy of the dental implant surgery to a certain extent.

Contents of the invention

In order to solve the real-time positioning problem of the mandible when the robot surgical system performs dental implant operation on the patient, as well as the stability problem of the mandible under the action of surgical operating force and the resulting surgical accuracy problem, the present invention proposes a method for A jaw positioning and fixation device for navigation, positioning and mandibular fixation during robotic dental implant surgery.

The technical solutions adopted by the present invention to solve the technical problems are:

A jaw positioning and fixing device used for navigation, positioning and mandibular fixation during robotic dental implant surgery, including an oral opener, a tongue baffle, a mandibular tray, a skull bracket, a directional movement positioner and a surgical positioning device for image navigation marker;

Both sides of the skull support are connected to the oral cavity opener through two telescopic mechanical devices centered on the rotation-telescopic mechanical device. The tongue baffles are connected to both sides of the lower end of the oral cavity opener. Both ends of the mandibular tray They are respectively connected to the oral opening device through another telescopic mechanical device. The directional movement locator is installed on the telescopic mechanical devices connected to both sides of the skull support. The surgical positioning marker for image navigation is fixed symmetrically on the directional movement locator. On the center line, dials are installed on the opening angle of the oral cavity opener, the rotation-telescopic mechanical device and all telescopic mechanical devices.

Further, the telescopic mechanical device includes a sliding sleeve, a sliding rod, a knob and a screw. The sliding rod is slidably located inside the sliding sleeve. There is a corresponding threaded hole on the surface of the sliding sleeve, and one end of the screw passes through the threaded hole. In contact with the sliding rod, the other end of the screw is fixedly connected to the knob. The knob controls the forward/reverse movement of the screw to generate friction on the sliding rod, thereby fixing/loosening the sliding rod, thereby adjusting the length of the telescopic mechanical device.

The rotary-telescopic mechanical device includes a telescopic mechanical device and a rotating mechanical device. The telescopic mechanical device includes a sliding sleeve, a sliding rod, a knob and a screw. The sliding rod is slidably located inside the sliding sleeve. The surface of the sliding sleeve is open. There is a corresponding threaded hole, one end of the screw passes through the threaded hole and contacts the sliding rod, and the other end of the screw is fixedly connected to the knob; the rotating mechanical device includes a centering rotor and a wheel disk, and a wheel disk is provided on the sliding rod , the wheel disk is rotatably installed on the centering rotor, and the wheel disk is the rotation output end of the rotation-telescopic mechanical device.

Furthermore, the oral cavity opener is composed of a jaw-type support ferrule and a spring locking device with a dial; it is used to open the patient's upper and lower jaws and measure their opening angles.

The scales include linear scales for measuring all telescopic lengths on the device and arcuate scales for measuring rotation angles.

The directional movement positioner is composed of a telescopic mechanical device in two directions perpendicular to the horizontal plane and the coronal plane of the human body. The knobs on the telescopic device are used to fine-tune the above two directions to accurately control the position of the surgical positioning marker.

The skull support consists of two layers: an inner layer and an inner layer. The inner layer is made of soft pads and is used to contact the contour of the patient's skull; the outer layer is made of a plastic shell and is used to generate supporting force that is transmitted to the mandibular tray and then cooperates with the mouth opener to stabilize the mandible. , the telescopic mechanical device on the symmetry axis of the skull bracket is fixedly connected to both ends of the outer layer of the bracket, and is used to adjust the overall width of the positioning and fixing device.

The beneficial effects of the present invention are mainly manifested in: 1. The mandibular positioning and fixation device replaces the operator's hand support of the mandible required in traditional dental implant surgery, avoiding interference during robot surgery; 2. The robot performs the mandibular operation During the cavity preparation process, the mandibular fixation device provides guarantee for the static stability of the mandible, greatly improving the accuracy of the cavity preparation process for implant surgery; 3. The surgical positioning marker used for image navigation on this device is fixed at a higher position than before. The method in the patient's mouth increases the operating space for oral surgery and improves the safety of dental implant surgery; 4. Solve the problem of position deviation of the original surgical positioning marker when worn twice before and during surgery, further improving Surgical navigation positioning accuracy.

Description of drawings

Figure 1 is an overall schematic diagram of the jaw positioning and fixing device used for navigation, positioning and mandibular fixation in robotic dental implant surgery according to the present invention.

Figure 2 is a schematic diagram of the left side view of the rotation-telescopic mechanism on the mandibular fixation device.

Detailed ways

The present invention will be further described below in conjunction with the accompanying drawings.

Referring to Figures 1 and 2, a jaw positioning and fixing device used for navigation, positioning and mandibular fixation during robotic dental implant surgery includes an oral cavity opener 6, a tongue baffle 10, a mandibular tray 9, a skull bracket 1, and a direction. Mobile positioner 15 and surgical positioning marker for image navigation;

Both sides of the skull support 1 are connected to the oral cavity opener 6 through two telescopic mechanical devices 5b and 5c centered on the rotation-telescopic mechanical device 5e. The tongue baffles 10 are connected to both lower ends of the oral cavity opener 6. On the other side, the two ends of the mandibular tray 9 are respectively connected to the oral cavity opener 6 through another telescopic mechanical device 5d, and the directional movement positioner 15 is installed on the telescopic mechanical devices 5b connected to both sides of the skull support. The navigation surgical positioning marker 8 is fixed on the symmetrical center line of the directional movement positioner 15. A dial 3 is installed at the opening angle of the oral cavity opener 6, the rotation-telescopic mechanical device and all telescopic mechanical devices.

Further, the telescopic mechanical device includes a sliding sleeve 13, a sliding rod 14, a knob 12 and a screw 11. The sliding rod 14 is slidably located inside the sliding sleeve 13. The sliding sleeve 13 has corresponding threaded holes on its surface. One end of the screw 11 passes through the threaded hole and is in contact with the sliding rod 14. The other end of the screw 11 is fixedly connected to the knob 12. The knob 12 is used to control the screw forward/reverse to generate friction on the sliding rod 14, thereby fixing/loosening the sliding rod 14. , thereby adjusting the length of the telescopic mechanical device.

The rotary-telescopic mechanical device includes a telescopic mechanical device and a rotating mechanical device. The telescopic mechanical device includes a sliding sleeve 13, a sliding rod 14, a knob 12 and a screw 11. The sliding rod is slidably located inside the sliding sleeve. There is a corresponding threaded hole on the surface of the sliding sleeve, one end of the screw passes through the threaded hole and contacts the sliding rod, and the other end of the screw is fixedly connected to the knob; the rotating mechanical device includes a centering rotor and a wheel disc, and the sliding rod A wheel disk is provided on the rotor, and the wheel disk is rotatably mounted on the centering rotor. The wheel disk is the rotation output end of the rotation-telescopic mechanical device.

Furthermore, the oral opening device 6 is composed of a jaw-type support ferrule and a spring locking device 7 with a dial; it is used to open the patient's upper and lower jaws and measure their opening angles.

The scales include linear scales 3a, 3c, 3d, 3f for measuring all telescopic lengths on the device and arcuate scales 3b, 3e for measuring rotation angles.

The directional movement positioner 15 is composed of two telescopic mechanical devices 5a and 5b that are perpendicular to the horizontal plane of the human body and the coronal plane. The above two directions are fine-tuned through the knob on the telescopic device to accurately control the position of the surgical positioning marker.

The skull support 1 includes two inner and outer layers. The inner layer 2 is made of soft pads and is used to contact the patient's skull contour. The outer layer 4 is made of a plastic shell and is used to generate supporting force and transmit it to the mandibular tray to cooperate with the mouth opener. To stabilize the mandible, the telescopic mechanical device 5f on the symmetry axis of the skull bracket is fixedly connected to both ends of the outer layer of the bracket and is used to adjust the overall width of the positioning and fixing device.

The tongue baffle 10 is made of non-toxic medical materials and is used to prevent the patient's tongue from swimming to the alveolar bone during the operation and interfering with the operation of the robot.

The mandibular tray 9 is a fixed plate similar in shape to the mandible, used to support the patient's mandible, and cooperates with the mouth opening device to fix the movement of the mandible after the patient opens his mouth.

The surgical positioning marker for image navigation includes multiple easy-to-identify infrared marking points for precise intraoperative robot positioning.

The implementation process of this embodiment is as follows: for patients who come for dental implants, they first wear the jaw positioning and fixing device, then take CT data, and perform operations such as plaster impression taking, model registration, and implant surgery plan design. Before the operation begins, the surgeon puts the device on the patient again to help complete the robotic dental implant surgery. Specific steps are as follows:

The first step is to wear the above device on the patient's head, and find the basic fitting position between the bracket 1 and the patient's skull by moving the jaw positioning device and roughly adjusting the telescopic mechanical device 5f on the skull bracket 1;

In the second step, the patient opens his mouth, and the doctor adjusts the mouth opening 6 on the device as well as the coarse adjustment telescopic mechanical device 5b, 5c, 5f and the rotation-telescopic mechanical device 5e according to the actual size of his or her mouth, so that the mouth opening is aligned with the upper part of the mouth. The mandible is stably supported and the jaw positioning and fixing device coordinately fits the patient's head, and the locking spring device 7;

The third step is to adjust the telescopic mechanical device 5d and move the mandibular tray 9 until the tray is close to the mandible, adjust the skull bracket 1 to find the best fit position with the skull;

The fourth step is to fine-tune all telescopic mechanical devices and rotation-telescopic mechanical devices so that the entire jaw positioning and fixing device is in coordinated and close contact with the patient's head. At the same time, tighten all the knobs on the device so that the entire jaw positioning and fixing device is in close contact with the patient's head. Completely locked;

The fifth step is to use the uppermost point of the patient's own auricle and the most protruding point of the tip of the nose as the upper and lower and front and back reference points respectively to fine-tune the direction of the mobile positioner 15 to determine the best position of the navigation surgery positioning marker 8 in the surgical area;

The sixth step is to record all the dial 3 data on the mandibular positioning and fixation device at this time, and take CT scans and intraoral plaster impressions of the patient;

The seventh step is to analyze the patient's CT data, reconstruct the jaw model and a three-dimensional model including markers based on the CT data, reconstruct the inner surface model of the outlet based on the plaster model scan data, and perform model registration. On this basis, a three-dimensional model is designed. Implant surgery plan, as well as designing surgical guides and other operations;

Step 8: Before the operation begins, the patient wears the mandibular positioning and fixation device again. Based on the preoperative recorded data, the device is fine-tuned to completely coincide with the position worn before the operation, so that the mandible is fixed and remains stable during the operation. At the same time, through the visual positioning system in the robot system, the positioning marker 8 is aligned with the marker in the three-dimensional model, thereby ensuring that the three-dimensional surgical plan is completely consistent with the spatial position of the patient's oral cavity. At this time, the robotic dental implant surgery is performed. The dental implant plan planned before surgery can be accurately realized in the patient's mouth through the robotic surgical system.

The content described in the embodiments of this specification is only an enumeration of the implementation forms of the inventive concept. The protection scope of the present invention should not be considered to be limited to the specific forms stated in the embodiments. The protection scope of the present invention also extends to this field. Equivalent technical means that a skilled person can think of based on the concept of the present invention.

Claims (5)

1. A jaw location fixing device that is arranged in robot implant operation in-process navigation location and mandible fixed, its characterized in that: comprises an oral cavity mouth gag, a tongue baffle, a mandibular tray, a skull support, a directional movement positioner and an operation positioning marker for image navigation;

the two sides of the skull support are connected with the oral cavity opening device through two telescopic mechanical devices which are connected with each other by taking the rotary mechanical device as a center, the tongue baffle is connected with the two sides of the lower end of the oral cavity opening device, the two ends of the mandibular tray are respectively connected with the oral cavity opening device through another telescopic mechanical device, the direction moving positioner is arranged on the telescopic mechanical devices which are connected with the two sides of the skull support, the operation positioning marker for image navigation is fixed on the symmetrical central line of the direction moving positioner, and the opening angle of the oral cavity opening device, the rotary mechanical device and the telescopic mechanical device are provided with dials;

the telescopic mechanical device comprises a sliding sleeve, a sliding rod, a knob and a screw, wherein the sliding rod is slidably positioned in the sliding sleeve, a corresponding threaded hole is formed in the surface of the sliding sleeve, one end of the screw passes through the threaded hole to be in contact with the sliding rod, the other end of the screw is fixedly connected with the knob, and the knob is used for controlling the screw to advance/retreat to generate friction force on the sliding rod so as to fix/loosen the sliding rod, so that the length of the telescopic mechanical device is adjusted;

the rotary mechanical device comprises a centering rotor and a wheel disc, wherein the wheel disc is arranged on the sliding rod and is rotatably arranged on the centering rotor, and the wheel disc is a rotary output end of the rotary mechanical device.

2. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the oral cavity mouth gag consists of a dental supporting cutting sleeve and a spring locking device with a dial.

3. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the scale comprises a linear scale for measuring all telescopic lengths on the device and an arc scale for measuring the rotation angle.

4. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the direction moving positioner is formed by combining telescopic mechanical devices in two directions perpendicular to the horizontal plane and the coronal plane of a human body.

5. A jaw positioning fixture for navigational positioning and mandibular fixation during robotic dental implant surgery as claimed in claim 1, wherein: the skull support comprises an inner layer and an outer layer, wherein the inner layer is composed of a soft cushion, the outer layer is composed of a plastic shell, and a telescopic mechanical device on the symmetry axis of the skull support is fixedly connected with two ends of the outer layer of the support.