Patent Application
20210077231
The present invention relates to the field of prosthodontics and particularly, though not exclusively, to a dental tray assembly for collecting data for imaging a patient's edentulous arches and palate; and to a method of imaging edentulous arches and palate for use in the subsequent design and manufacture of dental prostheses.
Conventional methods for the design and manufacture of dental prostheses typically require the creation of physical impressions of a patient's arches. This is a manual process which involves preparing a suitable impression compound, e.g. in the form of a paste, and placing it within an impression tray which is then applied to the edentulous arches and allowed to set.
There are numerous disadvantages associated with conventional methods. For example, it is typically necessary for a patient to attend multiple dental appointments over a period of several weeks. Various positive and negative moulds are produced during successive appointments to create custom-fit trays, to determine bite position, to produce finalised prostheses, and then to test their fit and make any necessary minor adjustments. The use of viscous impression materials means the procedure is often messy, may be uncomfortable, is inevitably time-consuming for both the patient and practitioner, and is expensive.
Ultimately, the comfort and stability of prosthetic dentures rely on a highly accurate match between the interface of the prosthesis and the corresponding surface topography of a patient's arches. Conventional techniques may not always provide a match of sufficient accuracy due to the multiple opportunities for human error within the overall process. Unintended movement of the impression tray within the oral cavity, premature removal of the impression tray, and the presence of air bubbles within the impression material are just three possible ways in which errors can arise.
Moreover, such conventional techniques are incapable of detecting subsurface features of the edentulous arches such as variations in gum tissue depth relative to the underlying bone at any given point. Ignoring subsurface features of the edentulous arches may result in an uneven transmission of mechanical stresses at the interface between the prosthesis and the underlying soft tissue of the edentulous arches. This may result in patient discomfort and possible rejection of prostheses.
More recently, intraoral digital scanning techniques have been developed whereby a hand-held wand is inserted into the oral cavity to produce near instantaneous virtual impressions without the need for physical contact with intraoral palate. One such scanner is the TRIOS® scanner offered by Danish firm, 3Shape A/S. Ultrasonic imaging probes are also known which employ piezoelectric transducers to produce virtual impressions. Such digital scanners help to eliminate some of the aforementioned instances of human error which arise when prostheses are manufactures on the basis of physical impressions. By providing manufacturing labs with more precise and reliable representations of the oral topography which are not reliant on multi-step manual processes, accuracy can be improved.
However, hand-held digital scanners typically require a practitioner to manually manoeuvre a bulky scanning head around the mouth to cumulatively build a rendered image of the overall intraoral cavity and edentulous arches. This typically involves manually distorting the lips and cheeks and associated muscles to enable the scanning head to image the gingival sulci. Moreover, whilst intraoral scanners are capable of capturing highly accurate images of the dentulous mouth, they are less capable of doing so for the edentulous mouth due to the relative absence of fixed reference points.
In recognising the drawbacks of existing intraoral scanning techniques, the inventor of the present invention has devised a new apparatus and associated method which overcomes, or at least ameliorates, one or more of the aforementioned problems.
According to a first aspect of the present invention there is provided a dental tray assembly for intraoral imaging of an edentulous dental arch and/or palate; the dental tray assembly comprising:
It will be appreciated that each imaging element is located within the base and/or anterior wall of the trough to thereby define a series of fixed imaging reference points.
Optionally, the array of ultrasound imaging elements are spaced apart across the entirety of the base surface and/or the anterior wall.
It will be appreciated that by distributing the imaging elements across a wide surface area of the dental tray, this allows for simultaneously imaging of multiple locations within an edentulous arch and/or palate, i.e. the entire arch and/or palate can be imaged substantially instantaneously.
Optionally, a gel-filled sac is removably locatable within the arcuate trough to provide a deformable interface between the dental tray and a patient's edentulous arches and/or palate.
Optionally, the gel is a water-based gel.
Alternatively, the gel within the gel-filled sac is a heat-sensitive settable gel for forming an impression of anatomical surface features of the oral cavity including one or more of the group comprising the palate, ridges and sulci.
Optionally, the sac is formed from a synthetic latex material.
It will be appreciated that employing a water-based gel as an interface between the ultrasound imaging elements and the edentulous arches and palate will help to eliminate undesirable reflection of ultrasound waves. Any distortion in the ultrasound signals can be minimised by ensuring that the acoustic impedance value of the gel material is substantially matched to that of the edentulous arches and palate.
Optionally, the gel-filled sac is dimensioned such that it fills the arcuate trough and extends above the height of the anterior trough wall.
It will be appreciated that the deformable nature of the gel will gently conform to the natural surface topography of the edentulous arches and palate whilst also ensuring that no part of the dental tray will directly contact a patient's edentulous arches and/or palate during use.
Optionally, the gel-filled sac comprises an attached sheath adapted to envelop the dental tray.
Optionally, the ultrasound imaging elements are non-piezoelectric.
Optionally, the ultrasound imaging elements are printed on a flexible foil which is conformable to the concave internal surface of the dental tray.
It will be appreciated that the flexible foil may additionally be overlaid on one or more of the external concave surfaces of the dental tray.
Optionally, a handle portion projects away from the anterior trough wall and, in use, extends out of the oral cavity.
Optionally, a camera is located on the handle for detecting, in use, the position of reference points on a patient's face relative to a patient's mouth.
It will be appreciated that the camera viewing angle will be determined by its position on the handle and/or the length of the handle so as to be directed towards, for example, the eyes and/or nose and/or ears of a patient. Other suitable fixed facial landmarks such as, but not limited to, freckles, moles, scars etc may also be used.
Optionally, the ultrasound imaging elements are connected to a power source located in the handle portion.
It will be appreciated that the ultrasound imaging elements may alternatively be connectable to an external power source, via a power cord.
Optionally, an aperture is formed in the anterior trough wall to facilitate a physical connection between the power source and the ultrasound imaging elements.
Optionally, the ultrasound imaging elements are connectable to an external processing device.
Optionally, the camera is connectable to an external processing device.
Optionally, the external processing device is a mobile or tablet device.
According to a second aspect of the present invention there is provided a method of imaging edentulous arches and/or palate comprising the steps of:
Optionally, the step of receiving a primary data set from the ultrasound imaging elements includes processing said data in a processing device.
Optionally, the step of processing the primary data set includes storing the processed data set in a memory for future use.
Optionally, the step of processing the primary data set includes providing a display for displaying a synchronous rendered image of a patient's edentulous arches and/or palate.
It will be appreciated that the primary data set may be processed remotely on, for example, a smartphone, tablet device or other ancillary device. A three-dimensional image may be displayed showing sub-surface features of the edentulous arches and/or palate. The images may be manipulated by software to show a realistic coloured rendered image of the soft tissue in its existing relaxed form. From this, it is possible to determine tissue depth relative to the underlying bone at any given point thus enabling the design of bespoke prostheses which compress the soft tissue to an optimal degree for comfort, stability and retention within a patient's mouth.
The dental trays and gel-filled sacs according to the present invention may be purchased by a patient such that the method of imaging the edentulous arches and/or palate can be performed outside of a clinical environment, e.g. at home. Advantageously, the apparatus of the present invention may be used by a patient to image their own edentulous arches and/or palate and place a remote order for replacement prosthesis using a software App on a smartphone, tablet or other device.
Optionally, the step of locating a gel-filled sac within the arcuate trough of the dental tray is preceded by a step of enveloping the dental tray in a protective sheath.
Alternatively, the step of locating a gel-filled sac within the arcuate trough of the dental tray includes enveloping the dental tray in a protective sheath which is formed integrally with the gel-filled sac.
It will be appreciated that enveloping the dental tray with a protective sheath provides a hygienic barrier facilitating re-use of the dental tray by different patient.
Optionally, the step of locating a gel-filled sac within the arcuate trough includes providing a heat-settable gel-filled sac; subjecting the gel-filled sac to natural intraoral heating; and allowing it to set thus forming a durable impression of the imaged dental arch and/or palate.
Optionally, the method includes the subsequent steps of removing the dental tray from an oral cavity; digitally scanning the set impression to obtain a secondary data set representative of the surface topography of a dental arch and/or palate; and combining said primary and secondary data sets to provide a composite rendered image of both surface and sub-surface features of the edentulous arches and/or palate.
It will be appreciated that dental prostheses manufactured using virtual/digital impressions can be created very accurately when those impressions are formed from a composite or hybrid data set. In particular, the interface fit between such prostheses and a patient's intra-oral surfaces can be greatly improved. By both accurately matching the surface topography of the edentulous arches and adjoining palate; and by taking due account of substructure features such as the depth variation of soft tissues relative to underlying bone structures, mechanical stresses during use are balanced and patient discomfort and instances of patient rejection of prostheses are eliminated, or at least minimised. Furthermore, a rendered image of the entirety of the edentulous arches and/or palate can be obtained substantially instantaneously. This constitutes improvement upon existing digital scanners which typically require a scanning head of a hand-held wand to be manually manoeuvred around the edentulous arches in a progressive fashion to form a cumulative rendered image only once a sufficient number of reference points have been identified within the oral cavity.
Optionally, the method includes the further step of activating the camera to capture facial feature data which is then processed with said primary and secondary data sets.
It will be appreciated that capturing facial data, including the relative positions of a patient's eyes and nose (or other suitable anatomical landmarks), can help determine the proper position of the teeth on a prosthesis to be manufactured. Since the camera is located at a fixed position relative to the ultrasound imaging elements, by also determining the relative positions of a patient's eyes and/or nose (or other suitable anatomical landmark), this enables the position of the teeth to be approximated by software means.
According to a third aspect of the present invention there is provided a method of producing a dental prosthesis comprising providing a computer-readable medium having computer-executable instructions adapted to cause a 3D printer or milling machine to print a dental prosthesis, wherein the computer-executable instructions are created using a data set obtained by the second aspect.
Further features and advantages of the first, second and third aspects of the present invention will become apparent from the claims and the following description.
Embodiments of the present invention will now be described by way of example only, with reference to the following diagrams, in which:
Each of the ultrasound imaging elements 22 is connected to a power source (not shown) and a printed circuit board (not shown) located in a cavity formed inside the graspable handle 16 which also houses the electronic circuitry for operating the ultrasound imaging elements 22 and the camera 25. A control button 24 is provided towards the anterior end of the upper surface of the handle 16 for activating the ultrasound imaging elements 22. It will be appreciated that in some embodiments (not shown), the ultrasound imaging elements 22 may be activated automatically (or remotely) once the dental tray 10 is correctly positioned in the mouth, thereby obviating the need for a control button.
Also shown in
In some embodiments, a secondary sheath (not shown) envelopes the dental impression tray 10. The secondary sheath may be formed integrally with the gel-filled sac 26; or provided as a separate part. In either case, all surfaces of the dental impression tray 10 are covered thus allowing its re-use by different patients.
In use, a thin sheath is arranged to envelop all exposed surfaces of the dental tray 10. A new gel-filled sac 26 is located on the base 12 of the dental tray 10 and overlies the spaced apart array of ultrasound imaging elements 22 situated on the inner side of the arcuate anterior wall 14 and/or the base 12. A further layer of water-based gel is applied to the upper surface of the gel-filled sac 26 before the dental tray 10 is inserted into a patient's oral cavity as indicated schematically in
Once correctly positioned, a dental practitioner (or the patient) may depress the control button 24 to actuate (perhaps after a delay) the spaced-apart array of ultrasound imaging elements 22. Each of the ultrasound imaging elements 22 emits a signal 23 (see
In a modified embodiment, a camera 25 records the positions of a patient's eyes and/or nose (or other suitable anatomical landmarks) relative to the ultrasound imaging elements 22 within the mouth. The camera 25 is also actuated by depressing the control button 24. This facial data is also communicated to the remote device 28 where it is processed along with the primary data set to allow the eventual position of prosthetic teeth to be approximated.
In a further modified embodiment, the gel-filled sac 26 comprises a heat-sensitive settable gel which sets when exposed, for a sufficient time-period, to intraoral heat. The gel adapts to the profile of the underlying tissue to thereby minimise any distorting pressure being applied on the tissue during capture of a scan.
In some embodiments, the various data sets communicated to the remote device 28 may be processed by software to provide a rendered simulation of an optimal degree of compression 30 subjected to the soft tissue 32 of the edentulous arches and/or palate at any given point by a dental prosthesis (see
It will be appreciated that the dental tray 10 of the present invention provides several advantages over conventional dental impression trays. Dental prostheses manufactured using virtual/digital impressions can be created very accurately, especially when those impressions are formed from a composite or hybrid data set. In particular, the interface fit between such prostheses and a patient's intra-oral surfaces can be greatly improved. By both accurately matching the surface topography of the edentulous arches and adjoining palate; and by taking due account of substructure features such as the depth variation of soft tissues relative to underlying bone structures, mechanical stresses during use are balanced and patient discomfort and instances of patient rejection of prostheses are eliminated, or at least minimised. Furthermore, a rendered image of the entirety of the edentulous arches and/or palate can be obtained substantially instantaneously. Use of the external camera 25 to collect and process facial data also provides a richer set of data which can be used to determine the size and relative positions of prosthetic teeth.
It is envisaged that the dental trays 10 and gel-filled sacs 26 may be purchased by a patient (or provided to a patient free of charge on a subscription basis) such that the method of imaging the edentulous arches and/or palate can be performed outside of a clinical environment. For example, the apparatus of the present invention may be provided as a kit for use by a patient at home to image their own edentulous arches and/or palate. A smartphone App would facilitate placing a remote order for bespoke replacement prosthesis which takes into account any changes in tissue or bone structure which may occur over time, and reduce the time, inconvenience and costs associated with the manufacture of dental prostheses.
Although a several embodiments of the invention have been disclosed herein, this has been done by way of example only. Those embodiments are not intended to be limiting with respect to the scope of the statements of invention and the appended claims. Indeed, it is contemplated by the inventor that various substitutions, alterations, and modifications may be made to the invention without departing from the scope of the invention as defined by the claims. For example, whilst the illustrated dental tray 10 is adapted for use with the edentulous arch and/or palate associated with the upper maxilla, an adapted shape can readily be adopted for use with the edentulous arch and/or palate associated with the lower mandible. Although reference throughout has been made to the edentulous arches, it will be appreciated that this term is intended to include partially edentulous arches. A plurality of ultrasound imaging elements 22 may additionally be provided on any or all of the external surfaces of the base 10 and/or arcuate anterior wall 14 of the dental tray. For example, sensors provided on the underside of the base 12 can be used to locate the antagonist, i.e. the opposing arch of the mandible or maxilla, to allow for more accurate design and positioning of a prosthetic. Bite pads provided with ultrasound imaging elements 22 to determine the location of the lower mandible relative to the upper maxilla and vice-versa.
Finally,
| Number | Date | Country | Kind |
|---|---|---|---|
| 1802402.6 | Feb 2018 | GB | national |
The instant application is a nationalization of PCT/GB2019/050394, filed on Feb. 14, 2019, presently pending, which in turn claimed priority to British application 1802402.6, filed on Feb. 14, 2018, presently pending, the contents of each application is hereby incorporated by reference.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/GB2019/050394 | 2/14/2019 | WO | 00 |
