Guide plate for preparing hole of implanted dental pit and manufacturing method thereof
Technical Field
The invention belongs to the field of tooth transplantation, and particularly relates to a dental implant prepared hole guide plate and a manufacturing method thereof.
Background
The autodental implant technique is to implant a donor tooth to a desired implant area in the same body. Clinically, autologous tooth transplantation is often used to treat dentition defects caused by caries, periodontitis, pulpal diseases or trauma. The implanted area for implantation may be an alveolar socket from which a diseased tooth is extracted immediately or an alveolar socket which is prepared by surgery. In the early stage of socket preparation, a receiving socket was tried directly from a donor tooth after the removal of the donor tooth, and the preparation was performed several times. However, the disadvantage of this preparation is that the long time of extraction of the donor tooth and the pressure of the fitted donor tooth root may impair the activity of periodontal ligament on the root surface, which is a key factor affecting the success rate of tooth implantation.
In recent years, the development of the autologous tooth transplantation technology is greatly promoted by computer virtual design and rapid prototyping technology. The individual donor tooth replica with the local splint and the operation template is designed and manufactured by utilizing the three-dimensional printing technology, and is applied to the autologous tooth transplantation operation, so that the operation time is shortened, and the survival rate of the transplanted tooth is improved. However, the prepared socket only depends on the hand feeling and experience of a doctor, the guiding design is insufficient, and the prepared implanted socket may deviate from the target position of the virtual design. Simulating the position and occlusion after the tooth implantation by using the computer virtual design; meanwhile, a digital operation guide plate is manufactured, the preparation precision of the dental socket in the implanted area is improved, and the depth and the angle of the ball drill are limited by the cylindrical hollow tube to prepare the dental socket. The method has the advantages that the treatment process becomes more predictive and accurate, the preparation precision of the dented pit is improved and the operation time is shortened compared with the traditional autodental transplantation. However, the digital surgical guide plate has a defect in design that the opening of the cylindrical guide tube is positioned at a higher position above the surface and is influenced by the opening degree of a patient, and a ball drill is not easy to enter the guide tube when preparing the alveolar socket. If the implantation direction is from distal to medial, the catheter opening is biased to distal, making the placement of the drill more difficult, and increasing the difficulty of the clinical procedure.
Disclosure of Invention
In view of the above, the present invention is directed to a dental implant preparation hole guide plate to solve the problem that the accuracy of the prepared dental socket of the implanted area is lower than that of the unmatched donor teeth.
In order to achieve the purpose, the technical scheme of the invention is realized as follows:
a dental implant cavity preparation hole guide plate comprises a first base plate and an implant guide sleeve arranged on the first base plate, wherein the first base plate is fixedly arranged on the periphery of an implanted area, and the implant guide sleeve is used for preparing a dental root cavity of a donor tooth.
Further, the contour of the inner ring of the transplanting guide sleeve is the same as the contour of the periphery of the tooth root of the donor tooth.
Furthermore, the cross section of the first base plate is of an arc-shaped structure, and the radian of the arc-shaped structure is the same as that of a dental arch of the implanted area.
Furthermore, caulking grooves are respectively formed in two ends of the first substrate, and the size of the inner ring of each caulking groove is the same as that of the periphery of the adjacent tooth.
Furthermore, a groove is formed in the lower end of the first base plate, and the contour of the inner ring of the groove is matched with the periphery of a dental arch and the periphery of a tissue surface.
Furthermore, the ball drill head is positioned at the inner ring of the transplanting guide sleeve, a stop piece is arranged on the ball drill handle, and one end of the stop piece is connected to the outer edge of the transplanting guide sleeve in a contact mode.
Compared with the prior art, the implant dental socket prepared hole guide plate has the following beneficial effects:
(1) the dental implant hole preparation guide plate provided by the invention is simple in structure and convenient to use, and reduces the difficulty of an autologous tooth implantation operation. The preparation precision of the dental socket in the implanted area is improved, the prepared dental socket guided to have a high matching degree with the dental socket in the virtual design, and in addition, the guide plate can also effectively ensure that the donor teeth are matched and occluded with the implanted area.
(2) The tooth transplantation pit prepared hole guide plate is positioned
Below the face, be convenient for the ball drill to get into the guide pin bushing and carry out the alveolar socket and prepare, reduced the requirement to patient's opening degree, increased the convenience of clinical operation.
(3) The prepared hole guide plate for the transplanted dental socket can greatly shorten the in-vitro time of donor teeth in the operation process, greatly protect the activity of periodontal ligament cells and improve the success rate of autologous tooth transplantation.
The invention also aims to provide a manufacturing method of the transplanting dental socket prepared hole guide plate, which aims to solve the problems of low manufacturing precision and low manufacturing efficiency of the transplanting dental socket prepared hole guide plate.
In order to achieve the purpose, the technical scheme of the invention is realized as follows:
a method for manufacturing a standby hole guide plate for a transplanted dental socket comprises the following steps:
s1, scanning the donor tooth and the implanted region through CBCT, analyzing the data of the donor tooth and the implanted region, and importing the data into design software;
s2, tracing donor teeth by software and labeling from maxilla and mandible;
s3, manufacturing a gypsum model, scanning the gypsum model through a 3D scanner, and importing data into design software;
and S4, three-dimensional reconstruction of the implanted area, the jaw bone and the donor tooth is carried out in the design software, and the three-dimensional model of the donor tooth is embedded into the implanted area to determine the three-dimensional model of the implanted area.
S5, generating a first substrate fixed on the periphery of the implanted area according to the three-dimensional model of the peripheral outline of the implanted area;
s6, making an opening on the first base plate according to the implanted region of the donor tooth, and making a transplantation guide sleeve model in the opening according to the peripheral contour of the donor tooth;
and S7, inputting the first substrate and the transplantation guide sleeve model data obtained in the step 6 into a 3D printer, and manufacturing and molding through the 3D printer.
Further, the analyzing of the donor tooth data in step 1 includes analyzing the mesial-distal and bucco-lingual widths, root length, neckline, root morphology, and crown to root ratio of the donor tooth.
Further, the analyzing of the data of the transplanted area in step 1 includes analyzing the width and height of the alveolar bone of the transplanted area, the distance from the donor tooth to the adjacent tooth after the donor tooth is transplanted, and the distance from the maxillary sinus or the lower alveolar nerve.
Further, the peripheral contour of the donor tooth in the step 6 comprises a cementum junction section contour and a root section contour from the cementum junction to the root tip layer by layer.
Compared with the prior art, the manufacturing method of the transplant socket prepared hole guide plate has the following advantages:
(1) the invention relates to a manufacturing method of a transplant dental socket prepared hole guide plate, which virtually designs a transplant position of a donor tooth through a computer, designs the transplant dental socket prepared guide plate to guide preparation of a transplanted dental socket, enables the size of a data model of the transplant dental socket prepared hole guide plate to be matched with the sizes of a transplanted area and the donor tooth, and meets the customization requirement through 3D printing of a manufacturing block.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate an embodiment of the invention and, together with the description, serve to explain the invention and not to limit the invention. In the drawings:
FIG. 1 is a schematic structural view of a dental implant preparation hole guide according to an embodiment of the present invention;
FIG. 2 is a top view of a dental implant socket prepared hole guide plate matching the contour of the cementum interface periphery according to an embodiment of the present invention;
FIG. 3 is a schematic structural view of a donor tooth according to an embodiment of the present invention;
FIG. 4 is a top view of the peripheral contour of the relative position of the axial direction of the tooth root to 2MM in accordance with an embodiment of the present invention matching the template of the prepared hole of the implant socket;
figure 5 is a top view of the peripheral contour of the relative position of the root axis to 8MM of the implant in accordance with an embodiment of the present invention mated with a dental implant preparation hole guide.
Description of reference numerals:
1-a first substrate; 2-transplanting a guide sleeve; 3-enamel cementum junction; 4-root of tooth.
Detailed Description
It should be noted that the embodiments and features of the embodiments may be combined with each other without conflict.
In the description of the present invention, it is to be understood that the terms "center", "longitudinal", "lateral", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like, indicate orientations or positional relationships based on those shown in the drawings, and are used only for convenience in describing the present invention and for simplicity in description, and do not indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and thus, are not to be construed as limiting the present invention. Furthermore, the terms "first", "second", etc. are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first," "second," etc. may explicitly or implicitly include one or more of that feature. In the description of the present invention, "a plurality" means two or more unless otherwise specified.
In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art through specific situations.
The present invention will be described in detail below with reference to the embodiments with reference to the attached drawings.
The implant socket preparation hole guide plate shown in fig. 1 comprises a first base plate 1 and an implant guide sleeve 2 arranged on the first base plate, wherein the first base plate 1 is fixedly arranged at the periphery of an implanted area, and the movable guide sleeve is used for preparing a root socket of a donor tooth. In the process of operation, a worker retains the first base plate 1 in an implanted area, the first base plate 1 stably guides a standby hole of a transplantation nest for transplantation operation, the inner edge line of the transplantation guide sleeve 2 is consistent with the contour of a dental neck line of a transplanted tooth, the direction of the transplantation guide sleeve 2 is coincident with the transplantation direction of the tooth to be transplanted, and the transplantation guide sleeve is used for preparing the dental root socket of a donor tooth.
In the process of transplanting the tooth socket prepared holes, a plurality of transplanting guide sleeves are needed, the inner edge contour of the transplanting guide sleeve 2 in each transplanting guide sleeve is different, the first base plate 1 is identical in structure, for example, five transplanting guide sleeves are prepared, firstly, the inner edge contour of the transplanting guide sleeve 2 in the used transplanting tooth socket prepared hole guide plate is identical to the peripheral contour of the enamel cementum boundary 3 of the donor tooth, the guide sleeves in the rest four transplanting tooth socket prepared hole guide plates are the transplanting guide sleeves 2 matched with the peripheral contour of the tooth enamel cementum boundary 3 of the donor tooth according to 2mm gradient, namely the axial relative position of the guide sleeves in the tooth roots 4 of the donor tooth is 2mm, 4mm, 6mm and 8mm deep, in application, the number of the tooth socket guide plates is manufactured according to the actual tooth root length of the donor tooth and the preset gradient size, and the description is omitted.
The cross section of first base plate 1 is the arc structure, the arc structure is the same with the dental arch radian of receiving the planting district, and the both ends of first base plate 1 are equipped with the caulking groove respectively, caulking groove inner circle size is the same with the peripheral size of adjacent tooth, and 1 lower extreme of first base plate is equipped with the recess, recess inner circle profile and dental arch periphery and the peripheral phase-match of tissue face, ball drill head are located 2 inner circles of transplantation uide bushing, and install the locking piece on the ball drill handle, and the one end contact of locking piece is connected to the outer fringe of transplanting uide bushing 2, combines the locking piece to restrict the prepared degree of depth of planter ball drill.
The manufacturing method of the implant dental socket prepared hole guide plate comprises the following steps:
s1, shooting a CT of the oral cavity of the patient, selecting a transplant donor tooth according to information such as the alveolar bone, the tooth root 4, the tooth crown, the tooth missing position and the like of the patient, and analyzing the donor tooth and an analyzed implanted area to ensure that the selected donor tooth can be matched with the implanted area; obtaining a digitized model of the patient's mouth by scanning the patient's mouth directly using an intraoral scanner or by scanning a model/impression of the patient's mouth using a model scanner; fitting CBCT data (namely bone information data) and digital model data acquired by a scanner and carrying out jaw three-dimensional reconstruction; reconstructing a three-dimensional model of a donor tooth, placing the donor tooth model into a tooth receiving area, enabling the implantation depth of the transplanted tooth to be consistent with that of an adjacent tooth, enabling the transplanted tooth to be free of interference with a tooth root 4 of the adjacent tooth, keeping a safe distance and enabling the transplanted tooth to be free of occlusion contact with jaw teeth, and determining the final implantation position of the donor tooth;
s2, virtually generating a first base plate 1 fixed on teeth according to the dentition form of a patient in the digital preoperative design software; then generating a transplantation guide sleeve 2 to limit the implantation ball drill used in the operation, wherein the inner edge of the transplantation guide sleeve 2 is set according to the cross section outline of the enamel cementum boundary 3; then, transferring the generated transplantation guide sleeve 2 to a position corresponding to a donor tooth on a base plate, and adjusting the inner edge of the transplantation guide sleeve 2 to ensure that the transplantation guide sleeve 2 of the transplantation nest prepared hole guide plate is respectively matched with the cross section outline of the enamel cementum interface 3 to obtain a transplantation nest prepared guide plate model;
s3, virtually generating a first base plate 1 fixed on teeth according to the dentition form of a patient in the digital preoperative design software; and then generating a plurality of transplanting guide sleeves 2 to limit the planting ball drills used in the operation, wherein the transplanting guide sleeves 2 are guide sleeves which are matched with the outer edge lines of the cross section contour of the tooth root 4 with the corresponding depth according to the depth of 2 mm/layer of bone, namely the depths of 2mm, 4mm, 6mm and 8mm are gradually increased layer by layer from the enamel cementum boundary 3 to the root tip. Then, transferring each generated transplanting guide sleeve 2 to a position, corresponding to a donor tooth, on the base plate, and adjusting the axial direction of the transplanting guide sleeve 2 to enable the axial direction of the transplanting guide sleeve 2 to be consistent with the implanting direction of the transplanted tooth, so as to obtain 4 guide plate models with prepared holes;
and S4, outputting all the operation guide plate models obtained in the steps 2 and 3 to a 3D printer in an STL format, printing by the 3D printer to obtain 1 transplant socket preparation guide plate and 4 root 4 socket preparation hole guide plates, combining the transplant socket preparation guide plate and the root 4 socket preparation hole guide plate to form the transplant socket preparation hole guide plate, and using the transplant socket preparation guide plate and the root 4 socket preparation hole guide plate one by one in the operation.
Wherein the step 1 of analyzing the data of the donor tooth comprises analyzing the near-far middle and buccal-lingual width, the length of the tooth root 4, the neck flange line, the shape of the tooth root 4 and the proportion of the tooth crown and the tooth root 4 of the donor tooth, and the step 1 of analyzing the data of the implanted area comprises analyzing the width and the height of the alveolar bone of the implanted area, the distance between the implanted donor tooth and the adjacent tooth and the distance between the implanted donor tooth and the maxillary sinus or the lower alveolar nerve tube.
The digital preoperative design software was the ProPlan CMF 3.0 software and the Mimics Medical 21.0 software.
The operation method for carrying out the autodental implantation operation by utilizing the implant dental socket prepared hole guide plate comprises the following steps:
a1, local anesthesia is carried out on the operation area.
A2, and minimally invasive extraction of teeth which cannot be reserved in the implanted area by workers.
A3, wear the hole baffle is equipped with to the transplanting nest on the tooth row of receiving the planting district, transplant the nest and be equipped with the hole guide and should laminate patient's maxillofacial completely, press the maxillofacial assurance baffle of baffle and stabilize and do not have and rock. The stop piece of the ball drill of the planter is fixed outside the mouth, the depth is 2mm, the ball drill of the planter (d is 2mm) is placed in the guide sleeve of the guide plate, the handle of the ball drill is tightly attached to the wall of the guide sleeve to keep vertical to start bone removal, and the transplanting nest is moved along the inner edge of the guide sleeve after the fixed depth is reached. And then, removing the transplanting socket prepared hole guide plate, sequentially replacing the tooth root 4 socket prepared hole guide plate with the depth of 2mm, 4mm, 6mm, 8mm and the like, putting a ball drill of the implanter with the corresponding stop depth fixed in a guide sleeve of the replaced guide plate, sequentially preparing the tooth root 4 sockets with different depths, trimming the inner wall of the tooth root 4 socket, and eliminating the step and the undercut of the inner wall until the tooth socket of the implanted area is prepared.
A4, after a dental socket of a to-be-implanted area is prepared, trying to implant a three-dimensional printing model of a to-be-implanted tooth, and if the model can be successfully positioned at a preoperative design position, completing the preparation; if not, the preparation is continued.
And A5, after the preparation is completed, minimally invasive extracting the donor tooth of the selected patient, and immediately implanting the donor tooth into the prepared dental socket.
And A6, elastically fixing the donor tooth by using resin and a thin steel wire.
And A7, adjusting the jaw of the donor tooth to ensure that no occlusion interference exists, and completing the transplantation of the autologous tooth.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents, improvements and the like that fall within the spirit and principle of the present invention are intended to be included therein.