Patent Application
20220249201
The goal of the orthodontic treatment planning process is to determine where the post-treatment positions of a person's teeth (setup state) should be, given the pre-treatment positions of the teeth in a malocclusion state. This process is typically performed manually using interactive software and is a very time-consuming process. A need thus exists for a final setup algorithm to serve as an efficiency enhancer, greatly reducing the time needed to process a case, along with a way to rate and evaluate treatment options.
A computer-implemented method for evaluating setups for orthodontic treatment of an embodiment of the invention includes receiving one or more setups, where each setup is a digital representation of a state of teeth at a particular stage of orthodontic treatment. Scores are computed based upon metrics related to at least some of the states represented by the corresponding setups, where the scores provide an indication of a validity of the corresponding states. The metrics along with an indication of the corresponding scores are displayed in order to provide a visual evaluation of the corresponding setups.
The accompanying drawings are incorporated in and constitute a part of this specification and, together with the description, explain the advantages and principles of the invention. In the drawings,
Described herein is an information management system, methods, and visualization tools to track, analyze, and visualize key orthodontic performance indicators for orthodontic treatment planning that can be used to evaluate and adapt intermediate and final setups and to communicate this information effectively to a clinician and patient.
The dashboard would provide real-time feedback to a doctor, technician, or patient as to the quality of their orthodontic treatment plan, allowing the user to design treatments more quickly and compare treatment alternatives. It would also inform a user when a treatment plan is sufficiently correct, meaning that time need not be spent attempting to improve the case further.
Applications of this technology include a fully automated treatment planning workflow, an interactive workflow to aid a clinician during treatment planning, and/or a visual communication tool during doctor-patient or technician-doctor interaction.
Embodiments of this invention include a suite of scoring methods and visualization tools for orthodontic treatment planning. The scoring methods enable automated intermediate and final setup generation for clear tray aligners. However, they provide many other opportunities in both automated and interactive treatment planning, including: computation of quantitative metrics to assess treatment plans, visualization of treatment options and trade-offs, and assessment of long-term effects of treatment options on holistic oral health (e.g., occlusal disease).
Further described herein is a method to visualize these metrics during orthodontic treatment planning to aid a user in treatment design.
The Orthodontic Metrics Generator (M), Analyzer (A), and User Requirements Generator (R) can be implemented with one or more processors or computing devices. The Local Trackers (T) and Data Storage (S) can be implemented with one or more electronic storage devices possibly with associated computing devices. The methods described herein can be implemented in software or firmware modules, for example, for execution by the processors or computing devices, and can alternatively be implemented in hardware modules or a combination of software and hardware.
Scoring Based on Geometric Information
A number of scoring methods may be used describe the validity of a state (arrangement of teeth) based on collisions between teeth. For example, a larger score may indicate a state that is worse, while a smaller score indicates a state that is closer to valid, with zero being a valid state, or alternatively larger scores may indicate better states.
Scoring Based on Physical Information
The geometric information discussed above can be used to provide physical information to inform treatment planning and facilitate effective communication with clinicians and patients. Scores may also be combined with other information, including landmarks, tooth movement between states, and tooth position to provide holistic oral health and comfort information. Such a system would go beyond being an orthodontic tool and rather serve as a unified treatment platform for dentists, orthodontists, and others.
Examples of Specific Scores
A list and short description of various metrics that may be computed and displayed for intermediate and final setups are described in co-owned US patent application filed on even date here and entitled “Method for Automated Generation of Orthodontic Treatment Final Setups” (U.S. Provisional Application No. 62/712,383, filed Jul. 31, 2018), which is incorporated herein by reference as if fully set forth. These metrics may be presented individually, or they can be combined to report more abstract qualities about the treatment. For example:
Bite comfort, bite alignment, treatment comfort, orthodontic correctness, and other metrics can also be used in a scoring function for final setup prediction.
Orthodontic metrics can be presented to a user in the form of a dashboard displayed on an electronic display device within a screen or user interface. The dashboard should be designed to strike a balance between the complexity of orthodontic metrics on the one hand, and user needs and capabilities for information processing on the other hand. The visual information in the displayed dashboard can be supplemented by auditory information, for example the metrics and related information provided in audible form via an electronic speaker.
Different user groups could electronically access the dashboard, including technicians, doctors, and patients.
For technician and doctor use, this tool could be used to modify or aid in the design of the final treatment setup. For patient use, it could be used as a communication tool for the doctor to convince the patient to undergo treatment, and to set realistic expectations for treatment duration and anticipated success at various stages of the treatment. It could also be used to compare different courses of treatment, for example it could be used to highlight how a one year course of clear tray aligners could bring all visible metrics to green or yellow status, while a three month course of treatment may address some qualities and probably not all, for example midline may be addressed but not occlusal relationship. It could also be used to compare treatments with different modalities, for example clear tray aligners versus brackets and wires, and how each affects the results the patient will see and feel on a regular basis.
Given different user needs of these user groups, and the number and complexity of the metrics to be potentially displayed, the dashboard should be adaptable to different user requirements as follows:
To achieve a user friendly design, the underlying metrics can be simplified for visualization to the user. This can be achieved in a number of ways:
Alerts would be useful for technicians and doctors during treatment design and for treatment evaluations.
The dashboard can display only those metrics that show insufficient performance. It alerts the user when any of the metrics are much different than an ideal case. For instance, if contact between any two teeth exceeds 0.15 mm, the user could receive an alert regarding this metric. To reduce information overload, other metrics could remain hidden, or summarized in an “all other good” indicator.
The alert could be displayed in a separate designed field (e.g., upper right corner of the screen or user interface). Additionally, for technicians and doctors, a related action panel could be highlighted.
Alerts can be arranged sequentially by deviation value in the display panel to indicate which metrics are most different from the ideal. This would indicate a severity of the deviation, and therefore an order of importance in which to revisit and correct metrics.
Colored fields ranging from green (all good) to yellow (caution) to red (alert) can be used to show to users in an intuitive view the status and change of multiple metrics when tracking treatment modifications, comparing malocclusions with final setups, comparing alternative treatment plans, and displaying anticipated treatment success over time to patients. The colored fields are represented herein by varying gray scale shades, and the status can be indicated by other colors or shading.
Heat maps could be designed with active fields: Users could click on a field and get a preview of the implicated teeth as shown in the example below.
Example: User selects edge alignment field on heat map at the right side of the dashboard and implicated teeth UR4 and UR3 are highlighted in the tooth overview at the bottom of the dashboard.
Trend data is informative for tracking treatment modifications. Improvements can be indicated by upward arrows, and worsening with downward arrows. This could be integrated with a heatmap.
Example: Display treatment planning over time/stages to patient with tooth and trend information: Shown is an example where one tooth (UR1) is initially moved out of a good alignment position to make room for another tooth (UR2, before both teeth are moved into a good alignment position
Line graphs can be used to display treatment development over time. For instance, initial movements may be slower than later ones, as displayed in the example.
Technicians or doctors may desire a more complex display than a heatmap. Bar graphs could be used for this purpose.
Arch with Heat Map
Metrics can also be visualized to a clinician or patient in an interactive tool by generating a heat map on the arch. For example, bite comfort is a display of the collisions and penetration depths at all locations along the arch. Large penetration depths indicate a poorly aligned bite and may be an early indicator of occlusal disease. Thus, this tool can help a patient and clinician choose among a set of orthodontic setups to identify a setup that minimizes risk of future damage. This tool could also be used to help a dentist plan occlusal treatment (e.g., addition or removal of material) or implants by displaying a tooth arch heat map to show how bite comfort would be affected following treatment.
To achieve a simplified display, for example, underlying metrics need to specified.
The acceptable thresholds for each metric could be specified manually by a user or prescribed by a doctor.
Standard values for each metric could be learned from past patient final setups, and measurements that deviate from the standard values by a large amount (e.g., midline discrepancy larger than 95% of the population) would be highlighted to be revisited. Deviation from a standard value could be computed as:
(Measurement−Mean)/Standard Deviation (Eq. 1)
or, using a non-parametric approach:
(Measurement−Median)/Inner-Quartile Range (Eq. 2)
or:
Count(Population Metric>Measurement)/Count(Population) (Eq. 3)
Equation 3 describes the percentile score of the setup relative to the population (e.g., what percent of the population has a score that is better than the score of the current setup). The percentile score could change color based on how close to “normal” the current score is. For instance, green if the case is better than >90% of the population, yellow if it is better than >50% of the population, red otherwise.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/IB2019/056342 | 7/24/2019 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 62712380 | Jul 2018 | US |
