CN109009511B - Three-dimensional analysis tooth preparation guide plate manufacturing method based on 3D printing and use method - Google Patents
Three-dimensional analysis tooth preparation guide plate manufacturing method based on 3D printing and use method Download PDFInfo
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- 238000002360 preparation method Methods 0.000 title claims abstract description 72
- 238000000034 method Methods 0.000 title claims abstract description 36
- 238000010146 3D printing Methods 0.000 title claims abstract description 20
- 238000004519 manufacturing process Methods 0.000 title claims abstract description 17
- 238000004141 dimensional analysis Methods 0.000 title claims description 6
- 238000004458 analytical method Methods 0.000 claims abstract description 5
- 210000000214 mouth Anatomy 0.000 claims description 16
- 230000004048 modification Effects 0.000 claims description 4
- 238000012986 modification Methods 0.000 claims description 4
- 230000008676 import Effects 0.000 claims 1
- 230000008569 process Effects 0.000 abstract description 8
- 238000000227 grinding Methods 0.000 description 10
- 239000000463 material Substances 0.000 description 9
- 238000005520 cutting process Methods 0.000 description 8
- 239000011505 plaster Substances 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 229920002379 silicone rubber Polymers 0.000 description 3
- 229920006221 acetate fiber Polymers 0.000 description 2
- 206010006514 bruxism Diseases 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 238000003825 pressing Methods 0.000 description 2
- 230000008719 thickening Effects 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 229910052602 gypsum Inorganic materials 0.000 description 1
- 239000010440 gypsum Substances 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 230000009545 invasion Effects 0.000 description 1
- 239000003550 marker Substances 0.000 description 1
- 238000007639 printing Methods 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 229910010271 silicon carbide Inorganic materials 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
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- 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
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- 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
- A61C13/0006—Production methods
- A61C13/0019—Production methods using three dimensional printing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C5/00—Filling or capping teeth
- A61C5/20—Repairing attrition damage, e.g. facets
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
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Abstract
本发明公开了一种基于3D打印的三向分析备牙导板制作及使用方法。该基于3D打印的三向分析备牙导板制作方法包括以下步骤：（1）数字化模型获取；（2）虚拟设计目标修复体；（3）虚拟装配模型与目标修复体；（4）对虚拟装配模型和目标修复体后得到的整体模型做虚拟调整和修改，得到精细虚拟调整后的整体模型；（5）将备牙导板实体化；（6）3D打印备牙导板。本发明提供的备牙导板制作方法综合考虑了现有牙齿外形和未来修复体外形，从唇颊向、舌腭向、HE向三个方向对备牙过程实现全程数量控制，不受临床医生主观经验影响，可微创精准的完成牙体预备，全程数字化进行控制和操作，制作的流程简单，备牙的变形量非常小，提高了数据的有效性以及牙齿修复工程实现的效率。
The invention discloses a method for making and using a three-way analysis tooth preparation guide based on 3D printing. The 3D printing-based three-way analysis tooth preparation guide manufacturing method includes the following steps: (1) digital model acquisition; (2) virtual design of the target restoration; (3) virtual assembly of the model and the target restoration; (4) virtual assembly The overall model obtained after the model and the target restoration are adjusted and modified virtually, and the overall model after fine virtual adjustment is obtained; (5) The preparation guide is materialized; (6) The preparation guide is 3D printed. The preparation method of the tooth preparation guide plate provided by the present invention comprehensively considers the existing tooth shape and the shape of the future restoration body, and realizes the whole process of quantitative control of the tooth preparation process from the three directions of the labial and buccal, lingual and palatal directions, and is not subject to the clinician's subjectivity. Influenced by experience, the tooth preparation can be done minimally and accurately, and the whole process is digitally controlled and operated. The production process is simple, and the deformation of the tooth preparation is very small, which improves the validity of data and the efficiency of dental restoration engineering.
Description
Technical Field
The invention relates to a preparation guide of at least one tooth configured for preparing an oral restoration, in particular to a three-dimensional analysis tooth preparation guide plate manufacturing and using method based on 3D printing and a control method of tooth preparation amount of oral microscopic precise restoration.
Background
The process of dental restoration in most cases requires a dental preparation (grinding of the teeth into a given shape) and the wearing of the restoration on the ground teeth. There are three main techniques for preparing teeth: 1. preparing teeth by virtue of the subjective experience of a doctor; 2. preparing teeth by means of a fixed deep groove on a carborundum needle; 3. preparation is performed by means of a tooth preparation guide plate. Existing tooth profiles can provide maximum dental preparation data without stimulating the pulp or excessively damaging the strength of the tooth. Future restoration profiles may provide minimal tooth preparation data with guaranteed material strength and aesthetics. The first method lacks a quantitative concept throughout and is difficult to control the amount of teeth abraded. Although the second method uses a needle as a reference, the needle has poor correlation with the incision depth in the process of tooth preparation, and the tooth preparation amount is obtained in a safe range only by analyzing the existing teeth, so that analysis and consideration of future restorations are lacked. The third method can combine the existing tooth shape and the future restoration appearance, designs the preparation amount on the premise of ensuring the aesthetics and the function, and is a relatively better minimally invasive tooth preparation method at present. However, the existing tooth preparation guide plate is not smooth in the actual use process and the manufacturing process is very complicated. Firstly, a dentist needs to prepare a plaster model for recording the oral condition of a patient, an oral technician manually prepares an attractive wax model on the model by using wax, the appearance of a future prosthesis is simulated, the attractive wax model is copied by using a die material, and the plaster model is poured. Two types of tooth preparation guide plates can be manufactured at this time: 1. acetate fiber film pressing type guide plates; 2. silicon rubber guide plate group. The first method is to apply a film pressing machine on the poured plaster model to press an acetate fiber film on the surface of the model, take out the plaster model, and cut the formed guide plate. However, the plaster model is often damaged by violence during the taking-out process and the guide plate is deformed, so that the guide plate is not fit with the teeth clinically, and the control of various quantities during the tooth preparation process is inaccurate. The second method uses opaque silicon rubber, so to guide the preparation of teeth in different directions (labial, lingual and palatal, HE), it is usually necessary to copy a plurality of silicon rubber guide plates, and then make different incisions with a scalpel, so that the dentist can see the position relationship between the guide plates and the teeth during the tooth preparation process. The manufacturing process is complex, and due to the fact that the dental prosthesis is made of opaque materials, only the preparation amount of teeth at the incision can be mastered, and the overall control on the preparation of teeth is lacked.
Disclosure of Invention
The invention aims to provide a simple and effective tooth preparation guide plate manufacturing method and a using method thereof at the present time that the oral cavity restoration emphasizes accuracy and minimal invasion.
The technical scheme adopted by the invention is as follows:
a three-dimensional analysis tooth preparation guide plate manufacturing method based on 3D printing comprises the following steps:
(1) acquiring a digital model: obtaining an oral digital model of an oral condition by directly scanning the patient's oral cavity using an intraoral scanner or scanning a model/impression of the patient's oral cavity using a model scanner;
(2) virtually designing a target prosthesis: after the acquired oral cavity digital model is imported, the state of adjacent teeth, same-name teeth and opposite jaw teeth in the current oral cavity model is referred to carry out personalized design on teeth to be repaired, and the designed target prosthesis and the model are respectively exported.
(3) Virtual assembly of the model and the target prosthesis: after the designed target prosthesis and model data are imported and modeled, the model and the target prosthesis are assembled and combined into an integral model according to the characteristic that the inner cavity of the prosthesis is consistent with the outer cavity of the model with the same tooth position;
(4) virtually adjusting and modifying the integrated model obtained after virtually assembling the model and the target prosthesis to obtain a finely virtually adjusted integrated model;
(5) adjusting the thickness of the data of the tooth preparation guide plate, materializing the tooth preparation guide plate, extracting the shell of the rest models except the tooth preparation guide plate, and thickening the models in the direction far away from the surface of the tooth by 0.5mm to obtain the designed tooth preparation guide plate;
(6)3D printing of a tooth preparation guide plate: and guiding the designed tooth preparation guide plate into a 3D printer and manufacturing.
Wherein, the target prosthesis refers to the restored tooth.
Further, the virtual adjustment and modification of the preliminary overall model in step 4 specifically includes the following steps:
(4.1) virtually delimiting a prepared tooth area;
(4.2) performing virtual filling concave cavity treatment: a wax knife tool is used to properly increase the undercut area of the residual model and eliminate undercut, thereby reducing the change of the target prosthesis as much as possible;
and (4.3) virtually digging out the fixed-depth hole.
Further, step 4.1 specifically comprises the following steps,
(4.1.1), firstly, deleting the rest parts except 2 teeth on the left side and the right side of the target prosthesis by using a plane selection tool;
(4.1.2), then using a multipoint selection tool to perform pointing along the gingival margin of the rest teeth, deleting the gingival part and keeping the tooth part.
Further, step 4.3 specifically comprises the following steps,
(4.3.1), firstly, processing the lip and tongue surface deep hole fixing: and (3) aligning the residual model, drawing two trisection vertical lines in the gingival cutting direction and two trisection transverse lines in the mesial-distal direction on the labial surface and the lingual surface of the target prosthesis by using a linear tool, wherein the 4 lines divide the tooth body into 9 regions, and the central point of each region is the fixed deep hole of the labial surface and the lingual surface.
(4.3.2), secondly determining the cut end mark point: and (3) extending the trisection vertical line of the lip surface to a cutting end, and dividing the cutting end into three areas, wherein the central point of each area is the fixed deep hole of the cutting end.
And (4.3.3) finally, selecting and deleting the mark points in the three directions by using an ellipse selection tool to obtain the adjusted residual oral cavity model.
On the other hand, the invention provides a use method of a 3D printing tooth preparation guide plate, which specifically comprises the following steps:
step A, placing the prepared tooth preparation guide plate on teeth in the mouth of a patient;
step B, measuring a gap between the tooth surface at the position of the depth-setting hole and the surface of the tooth-preparing guide plate by using a depth-setting lathe needle, and when the measured gap is greater than or equal to the minimum thickness of a future prosthesis material, not performing tooth grinding treatment; when the gap is smaller than the minimum thickness of the future prosthesis material, grinding the tooth body at the position, wherein the grinding amount of the tooth body is the difference between the minimum thickness of the future prosthesis material and the measured gap;
c, grinding a set depth at the position of the fixed-depth hole by using a fixed-depth lathe needle according to the calculated tooth grinding amount, and marking black points at the bottom of the hole;
step D, taking down the prepared tooth guide plate, and uniformly grinding tooth tissues by using a depth setting lathe needle again until the black spots just disappear;
e, wearing the tooth preparation guide plate on the tooth and carrying out inspection and modification;
and F, further finishing the preliminarily repaired tooth body.
The 3D printing tooth preparation guide plate is manufactured according to the manufacturing method.
In summary, due to the adoption of the technical scheme, the invention has the beneficial effects that:
1. the method for manufacturing the tooth preparation guide plate comprehensively considers the shape of the existing tooth and the shape of a future prosthesis, realizes whole-process quantity control on the tooth preparation process from the labial and buccal direction, the lingual and palatal direction and the HE direction, is not influenced by the subjective experience of a clinician, and can complete tooth preparation minimally and accurately.
2. The method is based on a 3D printing technology, the whole process is controlled and operated in a digitalized mode, the manufacturing process is simple, a patient gypsum model does not need to be manufactured, and the beautiful wax pattern does not need to be manufactured manually.
3. The prepared tooth guide plate manufactured based on the method provided by the invention does not need to take out a plaster model violently, has very small deformation of prepared teeth and good fit with teeth of a patient, and improves the effectiveness of data and the efficiency of realizing tooth restoration engineering.
Drawings
The invention will now be described, by way of example, with reference to the accompanying drawings, in which:
FIG. 1 is a digital model of oral conditions taken in an embodiment of the present invention.
Fig. 2 is a schematic diagram of an overall model obtained by virtual assembly in the embodiment of the present invention.
FIG. 3 is a schematic diagram of the lip and tongue face deep hole treatment in the embodiment of the invention.
Fig. 4 is a schematic diagram of determining a cut-end marker point in an embodiment of the present invention.
Detailed Description
In order to make the technical solutions of the present invention better understood, the following description of the technical solutions of the present invention with reference to the accompanying drawings of the present invention is made clearly and completely, and other similar embodiments obtained by a person of ordinary skill in the art without any creative effort based on the embodiments in the present application shall fall within the protection scope of the present application.
Example 1
Embodiment 1 provides a three-dimensional analysis tooth preparation guide plate design based on 3D printing, the method including the steps of:
(1) acquiring a digital model: a digitized model of the oral condition is obtained 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, as shown in fig. 1, which is a schematic diagram of the obtained digitized model of the mouth.
(2) Virtually designing a target prosthesis: after the acquired oral cavity digital model is imported, the state of adjacent teeth, same-name teeth and opposite jaw teeth in the current oral cavity model is referred to carry out personalized design on teeth to be repaired, and the designed target prosthesis and the model are respectively exported. Wherein, the target prosthesis refers to the restored tooth.
(3) Virtual assembly of the model and the target prosthesis: the designed target prosthesis and model data are imported into three-dimensional modeling software, and the model and the target prosthesis are assembled and combined into an integral model according to the characteristic that the inner cavity of the prosthesis is consistent with the outer cavity of the model with the same tooth position, as shown in figure 2.
(4) Virtually adjusting and modifying the integrated model obtained after virtually assembling the model and the target prosthesis to obtain a finely virtually adjusted integrated model;
the virtual adjustment and modification of the preliminary overall model in the step 4 specifically comprises the following steps:
(4.1), virtually delimiting the prepared tooth area:
(4.1.1), firstly, deleting the rest parts except 2 teeth on the left side and the right side of the target prosthesis by using a plane selection tool;
(4.1.2), then using a multipoint selection tool to perform pointing along the gingival margin of the rest teeth, deleting the gingival part and keeping the tooth part;
(4.2) performing virtual filling concave cavity treatment: and (3) properly increasing the undercut area of the residual model by using a wax knife tool to eliminate undercut, thereby reducing the change of the target prosthesis as much as possible.
(4.3) virtually digging out the fixed-depth hole:
(4.3.1), firstly, processing the lip and tongue surface deep hole fixing: and (4) aligning the residual model, and drawing two trisection vertical lines in the gingival cutting direction and two trisection transverse lines in the mesial-distal direction on the labial surface and the lingual surface of the target prosthesis by using a linear tool. As shown in fig. 3, the 4 lines divide the tooth body into 9 zones, and the central point of each zone is the fixed deep hole of the labial surface and the lingual surface.
(4.3.2), secondly determining the cut end mark point: as shown in fig. 4, the trisection vertical line of the lip surface is extended to the cutting end, the cutting end is divided into three areas, and the central point of each area is the fixed deep hole of the cutting end.
And (4.3.3) finally, selecting and deleting the mark points in the three directions by using an ellipse selection tool to obtain the adjusted residual model.
(5) And (3) adjusting the thickness of the data of the tooth preparation guide plate, materializing the tooth preparation guide plate, extracting the shell of the rest models except the tooth preparation guide plate, and thickening the models in the direction away from the surface of the tooth by 0.5mm to obtain the designed tooth preparation guide plate.
(6)3D printing of a tooth preparation guide plate: outputting the designed tooth preparation guide plate into an STL format, and importing the tooth preparation guide plate into a 3D printer matched slicing and typesetting software for manufacturing.
And after printing is finished, performing subsequent processing according to the requirements of the printer.
Through the technical scheme provided by the embodiment 1, the corresponding 3D printing tooth preparation guide plate can be obtained, and the 3D printing tooth preparation guide plate can be used in actual repair engineering.
Example 2
The embodiment provides a use method of a 3D printing tooth preparation guide plate in actual restoration, wherein the 3D printing tooth preparation guide plate is manufactured by any one of the methods in the embodiments, and the use method specifically comprises the following steps:
and step A, placing the prepared tooth preparation guide plate on teeth in the mouth of a patient.
Step B, measuring a gap between the tooth surface at the position of the depth-setting hole and the surface of the tooth-preparing guide plate by using a depth-setting lathe needle, and when the measured gap is greater than or equal to the minimum thickness of a future prosthesis material, not performing tooth grinding treatment; when the gap is smaller than the minimum thickness of the future restoration material, the tooth body is ground, and the grinding amount of the tooth body is the difference between the minimum thickness of the future restoration material and the measured gap.
C. And grinding the tooth body to a preset depth at the position of the fixed-depth hole according to the calculated tooth body grinding amount by using a fixed-depth lathe needle, and marking black points at the bottom of the hole by using a pencil.
D. And taking down the prepared tooth guide plate, and uniformly grinding tooth tissues by using a depth setting lathe needle again until the black spots just disappear.
E. The tooth preparation guide plate is worn on the tooth and is checked and modified.
F. And further finishing the tooth body.
Therefore, based on the method for manufacturing the tooth preparation guide plate and the method for completing tooth restoration by using the tooth preparation guide plate, the existing tooth appearance and the future restoration appearance can be comprehensively considered, the tooth preparation can be accurately completed in a minimally invasive manner, the whole process is digitally controlled and operated, the manufacturing process is simple, and the effectiveness of data and the efficiency of realizing the tooth restoration project are improved.
Any feature disclosed in this specification (including any accompanying claims, abstract) may be replaced by alternative features serving equivalent or similar purposes, unless expressly stated otherwise. That is, unless expressly stated otherwise, each feature is only an example of a generic series of equivalent or similar features.
The invention is not limited to the foregoing embodiments. The invention extends to any novel feature or any novel combination of features disclosed in this specification and any novel method or process steps or any novel combination of features disclosed.
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