CN111803232B - Occlusal relationship-oriented implant surgical device for missing dentition and preparation method thereof - Google Patents

Abstract

The invention discloses a dentition missing implantation surgical device taking an occlusion relation as a guide and a preparation method thereof, wherein an implantation guide plate comprises a guide plate base body, the guide plate base body is prepared by obtaining the occlusion relation of a patient through 3D printing, and the guide plate base body is matched with the jaw bone shape and size of the patient; the guide plate base body is provided with a plurality of first fixing pin placing bodies, a plurality of osteotomy positioning bodies and an implantation site body; the first fixing needle placing body, the osteotomy positioning body and the implant site body are all provided with first guide holes; the temporary prosthesis is prepared by obtaining the occlusion relation of a patient through 3D printing, and is provided with a plurality of second retention needle placing bodies, and second guide holes are formed in the second retention needle placing bodies. The surgical device provides a dentition missing implantation surgical implantation guide plate taking an occlusion relation as a guide, the guide plate has a structure integrating retention, osteotomy and implantation sites, and the guide plate can ensure the accurate positioning of the temporary prosthesis.

Description

Occlusal relationship-oriented implant surgical device for missing dentition and preparation method thereof

technical field

The invention belongs to the department of oral implantology, and relates to the field of clinical research and supporting instruments of oral implantology, in particular to an occlusal relationship-oriented implantation surgical device for missing dentition and a preparation method thereof.

Background technique

The data show that the proportion of dentition loss in the elderly aged 65-74 is 4.5%. Dentition loss affects the jaw structure, aesthetics, pronunciation, chewing, and psychological state of patients. The World Health Organization defines this group of people as disabled. Traditional complete denture restorations can lead to persistent bone resorption in patients with edentulousness and a severe reduction in masticatory efficiency. The chewing efficiency of natural teeth is 200psi, and that of complete dentures is 50psi. After 15 years of wearing complete dentures, the chewing efficiency drops to 5.6psi.

The use of implant-supported restorations can effectively maintain bone mass, restore and maintain vertical occlusal distance, improve facial aesthetics, improve pronunciation, increase restoration success rate, improve chewing efficiency, reduce restoration size, and improve the stability of movable restorations and retention, increases the lifespan of restorations, and improves mental health. Therefore, implant-supported restorations are more and more widely used in the restoration and diagnosis of dentition patients.

However, a crucial point in the implant restoration of patients with missing dentition is often overlooked, that is, the determination of the jaw position. Because patients generally want to shorten the time of missing teeth, many clinical cases use the immediate load-bearing technique (immediately implant implants and immediately take impressions to determine the jaw relationship to make restorations). However, there are often errors in obtaining the patient's jaw relationship immediately after surgery. Once the jaw relationship is incorrectly determined, it will lead to a series of subsequent biological and mechanical complications. Therefore, it is very important to design diagnostic dentures to assess the correctness of jaw relationship in patients with missing dentition.

The implant design scheme for patients with missing dentition is complex, the number of implants is large, and the angle requirements are high. The application of digital technology, especially the application of implant guides, effectively reduces the difficulty of implantation for patients with missing dentition, and can guide the implant design through prefabricated temporary restorations. site.

However, the application of digital technology to implant restoration in patients with missing dentition currently has the following problems.

Problem 1: Most surgical implant guides for patients with missing dentition are mucosa-supported implant guides, but the accuracy of this guide is significantly lower than that of dental-supported guides. Therefore, establishing a standard edentulous model to obtain stable mucosal support and obtaining a stable occlusal relationship before surgery is the basis for digital implantation for edentulous patients.

Problem 2: Bone trimming is often required in the anterior teeth of patients with missing dentition. The osteotomy guide designed by digital technology is beneficial to accurately determine the position of the osteotomy. However, during the operation, the guide needs to be replaced and the processing cost is increased. Therefore, the development of a guide plate that integrates osteotomy and implant positioning has become the direction of the majority of implant researchers.

Problem 3: Digital technology can pre-fabricate temporary restorations before surgery. Immediately after surgery, the prefabricated restorations can be inserted into the chair, which greatly shortens the time at the chair. The accurate placement of the temporary denture can only be ensured when the implanted implant site is implanted with the aid of design and there is no difference in the implantation depth, which has great limitations in the clinical application process. Therefore, how to develop a temporary and immediate restoration with the guidance accuracy of the implant guide plate and the wide applicability of the surgical adjustment scheme has become an urgent problem to be solved in the research of edentulous implantation.

SUMMARY OF THE INVENTION

In order to solve the above problems, the present invention provides an occlusal relationship-oriented implantation surgical device for missing dentition and a preparation method thereof. The integrated structure of retention, osteotomy and implant site can ensure the accurate positioning of temporary and immediate restorations.

To achieve the above object, the present invention adopts the following technical means:

Occlusal relationship-oriented implant surgical devices for missing dentition, including:

An implant guide, the implant guide includes a guide base, the guide base is prepared by 3D printing by acquiring the occlusal relationship of the patient, and the guide base matches the shape and size of the patient's jaw; the guide base has a plurality of A first retaining pin placement body for fixing on the jawbone, a plurality of osteotomy positioning bodies for osteotomy and an implant site body matched with a patient's implanted site; the first retaining pin The placement body, the osteotomy positioning body and the implantation site body are all provided with first guide holes;

and a temporary prosthesis, the temporary prosthesis is prepared by 3D printing by obtaining the occlusal relationship of the patient, the temporary prosthesis has a plurality of second retention pin placement bodies, and the second retention pin placement body is provided with Two guide holes.

As a further improvement of the present invention, a plurality of the first retention pin placement bodies are arranged at different angles on the outer surface of the guide plate base body; the second retention pin placement bodies are arranged at different angles on the outer surface of the temporary restoration. external surface.

As a further improvement of the present invention, the first retaining pin placement body, the osteotomy positioning body, the implant site body and the second retaining pin placement body are all protruding bodies, and a guiding body is arranged on the protruding body, and the guiding body is The body is provided with a through hole to form a first guide hole or a second guide hole.

As a further improvement of the present invention, the guide body is made of metal material, and the guide bodies corresponding to the first retention pin placement body, the osteotomy positioning body, and the implant site body are distinguished by plating layers of different colors.

As a further improvement of the present invention, the guide plate base body is made of transparent material.

A manufacturing method of an occlusal relationship-oriented implantation surgical device for missing dentition, comprising the following steps:

S100, preparation of standard model of edentulous jaw; scanning and making of dentures; scanning dentures with well-sealed edges to shoot CT; CT data containing patient’s jaw information and scanned denture data containing occlusal relationship are fitted by blocking material, data Fitting to obtain the patient's jaw information, mucosal information and occlusal relationship information, so as to obtain a guide plate base model that conforms to the occlusal relationship;

S200, measure the intermaxillary distance between the upper and lower jaws of the patient, and set the osteotomy positioning body model according to the parameters required for post-repair;

S300, by measuring the jaw bone information of the patient, setting the first retaining pin placement body model according to the retaining pin parameters;

S400, set the implant site body model by measuring the jawbone and occlusal relationship information of the patient's implant site;

S500, using a 3D printing device to complete the occlusal relationship-oriented printing of the Trinity implant guide for patients with missing dentition;

In S600, a temporary restoration is fabricated with the guide plate base as a reference.

Optionally, in the step of preparing a standard model of an edentulous jaw, the impression is prepared and the edges are reshaped by a secondary impression method.

Optionally, in the step of scanning and manufacturing the denture, according to the standard of shifting the jaw position of the complete denture, the manufactured scanned denture should have good edge closure and a stable and repeatable occlusal relationship.

Optionally, in the data fitting step, one CT is used to simultaneously acquire jaw bone information and occlusal relationship information.

Optionally, the occlusal relationship information is collected by occlusal recording software.

Compared with the prior art, the present invention has the following technical advantages:

The implantation surgical device for missing dentition of the present invention is composed of an implantation guide plate and a temporary restoration. The implantation guide plate is used for osteotomy and implantation positioning. The guide plate can realize the integration of osteotomy and implantation sites, save operation time and cost, and is The surgeon provides precise osteotomy and implant site guidance.

The manufacturing method of the three-in-one implant guide plate of the present invention utilizes the occlusal relationship positioning device to provide a stable and repeatable guide plate position, so that the guide plate is consistent with the preoperative CT scanning denture to the greatest extent, so as to ensure the guide plate-guided implant operation and preoperative computer software The planning is consistent, and at the same time, through preoperative measurement and design, the implant guide, osteotomy guide, and transitional restoration can be integrated into a trinity, and an occlusal relationship-oriented trinity implant guide model can be established.

Description of drawings

The present invention will be further described in detail below with reference to the accompanying drawings and specific embodiments.

Fig. 1 is the labial and buccal side of the invented upper and lower jaw trinity implant guide plate, the placement position of the retaining pin, the positioning mark of the osteotomy and the mark of the implantation site can be seen;

Figure 2 is the occlusal view of the invented maxillary trinity implant guide for patients with missing dentition;

Figure 3 is an occlusal view of the mandibular trinity implant guide for a patient with missing dentition;

Fig. 4 is the occlusal guiding form of the trinity implantation guide of the invention;

Fig. 5 is a preoperative incomplete temporary restoration of the mandible invented based on the Trinity implant guide;

Fig. 6 is a complete temporary restoration after the invention based on the Trinity implant guide.

Among them, 100, guide plate base, 101, first retention pin placement body, 102, osteotomy positioning body, 103, implant site body, 104, guide hole; 200, occlusal recording software; 300, temporary restoration; 301, The second retaining pin placement body, 302, is a second guide hole.

Detailed ways

The present invention is a method for making a trinity implant guide for patients with missing dentition guided by an occlusal relationship, comprising the following steps:

(1) Preparation of standard model of edentulous jaw: using the standard impression-taking process of complete denture, first use the finished tray to make the initial impression, and then make individual trays and put them into the mouth for edge shaping, make the final impression, and pour plaster model to obtain a standard model of an edentulous jaw.

(2) Fabrication of scanning dentures: According to the standard of shifting the jaw position of complete dentures, determine the patient's jaw position, verify it after the intraoral try-in, and fill the completed scanning dentures with radio-blocking materials.

(3) Shooting CT: Let the patient wear a scanning denture with a well-sealed edge to shoot the oral cone beam CT, and shoot the CT of the scanning denture alone;

(4) Data fitting: Fit the CT data containing the patient's jaw information and the scanned denture data containing the occlusal relationship through the blocking material to obtain the patient's jaw information and occlusal relationship information;

(5) Guide plate design: measure the intermaxillary distance between the upper and lower jaws of the patient, and determine the position and height of the osteotomy positioning hole according to the needs of later repair (generally 15mm for a single jaw).

Measure the patient's jaw information, and design the retention pin placement marks, ie, the position parameters of the first retention pin placement body 101 and the osteotomy positioning body 102, according to the retention pin design principle. The retaining pin is a two-in-one guide for the positioning of the guide plate and the placement of the temporary restoration.

Measure the jawbone and occlusal relationship information of the patient's implantation site, design the implantation site mark, and obtain the position of the implantation site body 103 .

(6) Implant surgery: The Trinity Implant Guide for patients with missing dentition positioned according to the preoperative design is placed to complete the preparation of the implant socket and the insertion of the temporary restoration.

Wherein, in the preparation of the standard model of the edentulous jaw, the impression preparation is to be shaped by the edges according to the secondary impression method.

In the manufacture of the scanning denture, according to the standard of shifting the jaw position of the complete denture, the manufactured scanning denture should have good edge sealing and stable and repeatable occlusal relationship.

In the data fitting, one CT is used to simultaneously acquire jaw bone information, mucosal information and occlusal relationship information.

In the design of the guide plate, by measuring the intermaxillary distance between the upper and lower jaws of the patient, the osteotomy positioning hole is designed according to the needs of later repair (generally 15mm for a single jaw). The guide plate has dual functions of implant guide plate and osteotomy guide plate.

In the design of the guide plate, by measuring the information of the patient's jaw, the retention pin placement sign is designed according to the design principle of the retention pin. The guide plate has triple functions of implant guide plate, osteotomy guide plate and temporary restoration positioning.

In the design of the guide plate, the jawbone and occlusal relationship information of the patient's implant site is measured, and the implant site mark is designed.

The osteotomy information is copied on the implant guide plate, and the osteotomy can be completed by the osteotomy positioning device without changing the guide plate during the operation.

The temporary prosthesis placement sign is integrated with the retention pin placement sign, the temporary prosthesis is fabricated before surgery, and the temporary prosthesis placement sign is placed directly after surgery.

The implantation guide is printed according to the scanned denture template, and the accuracy of the guide is further improved by occlusal positioning and edge positioning.

Specifically, based on the Trinity planting guide, the following steps are included:

(1) Design of the osteotomy positioning mark: measure the intermaxillary distance between the upper and lower jaws of the patient, design the osteotomy positioning hole according to the needs of the later repair (usually 15mm for a single jaw), and place a positioning pin on the CT;

(2) Design of retention pin placement sign: By measuring the patient's jaw information, the retention pin sign was placed on CT according to the retention pin design principle;

(3) The design of the implant site logo: The implant site logo was designed by measuring the jawbone and occlusal relationship information of the patient's implant site.

(4) Printing guide: Use 3D printing device to complete the printing of the 3D implant guide for patients with missing dentition oriented by occlusal relationship, and place the collar;

(5) Occlusal record: use the printed secondary maxillary frame of the guide plate to complete the surgical occlusion record and try it on in the patient's mouth.

As shown in Figures 1 to 3, the occlusal relationship-oriented implantation surgical device for missing dentition obtained by the above method includes:

An implant guide, the implant guide includes a guide base 100, which is prepared by 3D printing by acquiring the occlusal relationship of a patient, and the guide base 100 matches the shape and size of the patient's jaw; the guide base 100 has a plurality of first fixation pin placement bodies 101 for fixing on the jawbone, a plurality of osteotomy positioning bodies 102 for osteotomy, and an implant site body 103 matching the site where the patient is implanted; The first retaining pin placement body 101, the osteotomy positioning body 102 and the implant site body 103 are all provided with first guide holes 104;

and a temporary prosthesis 300, the temporary prosthesis 300 is prepared by acquiring the occlusal relationship of the patient in 3D, and the temporary prosthesis 300 has a plurality of second retention pin placement bodies 301 for fixing on the jawbone, A second guide hole 302 is provided on the second retaining pin mounting body 301 .

As a preferred embodiment, a plurality of the first retention pin placement bodies 101 are arranged on the outer surface of the guide plate base 100 at different angles; the second retention pin placement bodies 301 are arranged at different angles on the temporary prosthesis 300 on the outer surface.

As a preferred embodiment, the first retaining pin placement body 101, the osteotomy positioning body 102, the implant site body 103 and the second retaining pin placement body 301 are all protruding bodies, and the protruding bodies are provided with guiding bodies, so The guide body is provided with through holes to form the first guide hole 104 or the second guide hole 302 .

As a preferred embodiment, the guide body is made of metal material, and the guide bodies corresponding to the first retaining pin placement body 101 , the osteotomy positioning body 102 , and the implant site body 103 are distinguished by plating layers of different colors.

As a preferred embodiment, the guide plate base 100 is made of a transparent material, such as a photosensitive transparent material.

The materials used in the present invention are all materials that meet the requirements of oral medical hygiene.

The modeling method of the three-in-one implant guide plate of the present invention uses the occlusal relationship positioning device to provide a stable and repeatable guide plate position, so that the guide plate is consistent with the preoperative CT scanning denture to the greatest extent, so as to ensure the guide plate-guided implant operation and preoperative computer The design is consistent, and at the same time, through preoperative measurement and design, the implant guide, osteotomy guide, and transitional denture can be integrated into one, and a occlusal relationship-oriented trinity implant guide model can be established.

The present invention will be described in detail below with reference to specific embodiments and accompanying drawings.

Example

The present invention has the following three purposes:

Objective 1: The three-in-one implantation guide plate is used to provide a method that can accurately locate the implantation site according to the stability of the mucosa and the accuracy of the occlusal relationship, thereby effectively improving the accuracy of the guide plate.

Objective 2: Under the premise of ensuring stable mucosal support and precise occlusal relationship of implant positioning, it can simultaneously have the function of a guide plate for guiding osteotomy.

Objective 3: In addition to realizing the above functions, the guide plate is used to design a temporary restoration with the guidance accuracy of the implant guide plate and the wide applicability of the surgical adjustment scheme.

Through the above three goals, a three-in-one implant guide with stable mucosal support and precise occlusal relationship guidance, osteotomy guide, and temporary restoration can be achieved.

In order to achieve the above object, the present invention adopts the following three technical solutions to achieve respectively.

Technical solution one:

A method for designing an implant guide for obtaining stable mucosal support guided by occlusal relationship in patients with missing dentition, comprising the following steps:

(1) Preparation of standard model of edentulous jaw.

(2) Scanning the production of dentures, ensuring good mucosal sealing through processes such as edge shaping and individual trays, so that the subsequent guide plate can obtain sufficient mucosal support.

(3) Wear a scanning denture with a well-sealed edge to take CT scans;

(4) Data fitting: Fit the CT data containing the patient's jaw information and the scanned denture data containing the occlusal relationship through the blocking material to obtain the patient's jaw information and occlusal relationship information, so as to facilitate the production of a guide plate that conforms to the occlusal relationship .

Technical solution two:

Adding the osteotomy positioning guide to the above implant guide includes the following steps:

(1) Design of the osteotomy positioning mark: measure the intermaxillary distance between the upper and lower jaws of the patient, design the osteotomy positioning hole according to the needs of the later repair (usually 15mm for a single jaw), and place a positioning pin on the CT;

(2) Design of retention pin placement sign: By measuring the patient's jaw information, the retention pin sign was placed on CT according to the retention pin design principle;

(3) Design of the implant site logo: The implant site logo is designed by measuring the jawbone and occlusal relationship information of the patient's implant site;

(4) Printing guide: Use a 3D printing device to complete the printing of the 3D implant guide for patients with missing dentition oriented by the occlusal relationship, and place the collar (Figure 1, 2, 3);

(5) Occlusal record: use the printed secondary maxillary frame of the guide plate to complete the surgical occlusion record and try it on in the patient's mouth.

The occlusal recording software 200 is actually used to confirm the occlusal recording, and the occlusal recording software 200 is made of soft material, such as silicon rubber.

Technical solution 3: The above-mentioned guide plate is used as a guide to make a temporary restoration, and finally the three-in-one function of the implant guide, the osteotomy guide and the temporary restoration is realized.

(1) Using the guide plate as a guide before surgery, and using the retaining pin on it as a positioning mark, an incomplete temporary restoration was made;

(2) After implantation, place the incomplete temporary restoration according to the position of the guide pin (Fig. 5);

Local micro-imaging was performed in the patient's mouth, and a full-body temporary restoration was fabricated in a short period of time (Fig. 6).

The foregoing has shown and described the basic principles, main features and advantages of the present invention. Those skilled in the art should understand that the present invention is not limited by the above-mentioned embodiments. What is described in the above-mentioned embodiments and the specification is only to illustrate the principle of the present invention. Without departing from the spirit and scope of the present invention, the present invention will also have various Such changes and improvements fall within the scope of the claims.

Claims (6)

1. An implant surgery device for missing dentition guided by occlusal relationship is characterized in that, comprising: An implant guide, the implant guide includes a guide base (100), the guide base (100) is prepared by 3D printing by acquiring the occlusal relationship of the patient, and the guide base (100) matches the shape and size of the patient's jawbone ; the guide plate base (100) is provided with a plurality of first fixation pin placement bodies (101) for fixing on the jawbone, a plurality of osteotomy positioning bodies (102) for osteotomy, and a plurality of osteotomy positioning bodies (102) and a patient An implantation site body (103) matched to the implanted site; a first guide hole is provided on the first retention pin placement body (101), the osteotomy positioning body (102) and the implantation site body (103) (104); and a temporary restoration (300), the temporary restoration (300) is prepared by 3D printing by obtaining the occlusal relationship of the patient, and the temporary restoration (300) is provided with a plurality of second retaining pin placement bodies (301) , a second guide hole (302) is provided on the second retaining pin placement body (301); The guide plate base (100) is made of photosensitive transparent material; The guide plate base (100) is prepared by 3D printing by acquiring the occlusal relationship of the patient, specifically, firstly, preparing a standard model of an edentulous jaw; scanning and making a denture; wearing a scanned denture with a well-sealed edge to take a CT; The CT data of the bone information and the scanned denture data containing the occlusal relationship are fitted by the blocking material, and the data fitting obtains the patient's jaw information, mucosal information and occlusal relationship information, thereby obtaining a guide plate base (100) model that conforms to the occlusal relationship; A plurality of the first retention pin placement bodies (101) are arranged on the outer surface of the guide plate base body (100) at different angles; the second retention pin placement bodies (301) are arranged at different angles on the temporary repair the outer surface of the body (300); The first retaining pin placement body (101), the osteotomy positioning body (102), the implant site body (103) and the second retaining pin placement body (301) are all protrusions, and a guide is provided on the protrusions The guide body is provided with a through hole to form a first guide hole (104) or a second guide hole (302); The guide body is made of metal material, and the guide bodies corresponding to the first retaining pin placement body (101), the osteotomy positioning body (102), and the implant site body (103) are distinguished by plating layers of different colors. 2. The method for making an occlusal relationship-oriented implant surgery device for missing dentition according to claim 1, wherein the method comprises the following steps: S100, preparation of standard model of edentulous jaw; scanning and making of dentures; scanning dentures with well-sealed edges to shoot CT; CT data containing patient’s jaw information and scanned denture data containing occlusal relationship are fitted by blocking material, data Fitting to obtain the patient's jaw information, mucosal information and occlusal relationship information, so as to obtain a guide plate base (100) model that conforms to the occlusal relationship; S200, measuring the intermaxillary distance between the upper and lower jaws of the patient, and setting the osteotomy positioning body (102) model according to the parameters required for post-repair; S300, by measuring the jawbone information of the patient, setting the model of the first retaining pin placement body (101) according to the retaining pin parameters; S400, set the implant site body (103) model by measuring the jawbone and occlusal relationship information of the patient's implant site; S500, using a 3D printing device to complete the occlusal relationship-oriented printing of the Trinity implant guide for patients with missing dentition; S600, a temporary restoration (300) is fabricated with reference to the guide plate base (100). 3 . The method for making an occlusal relationship-oriented implant surgery device for dentition according to claim 2 , wherein in the step of making the edentulous standard model, the impression is made according to a secondary impression. 4 . The edge of the legal line is reshaped. 4. The method for making an occlusal relationship-oriented implantation surgical device for missing dentition according to claim 2, wherein in the step of scanning and making dentures, making The finished scanned denture should have good edge closure and a stable and repeatable occlusal relationship. 5 . The method for manufacturing an occlusal relationship-oriented implant surgical device for missing dentition according to claim 2 , wherein in the data fitting step, one CT is used to simultaneously acquire jaw information and occlusal relationship information. 6 . 6. The method for manufacturing an occlusal relationship-oriented implant surgical device for missing dentition according to claim 2, wherein the occlusal relationship information is collected by an occlusal recording software (200).

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