The present invention relates generally to the field of restorative implant dentistry, and more particularly to systems and methods of designing and manufacturing dental abutments.
Dental abutments are used in restorative implant dentistry to join dental prostheses (artificial teeth) to dental implants (artificial teeth roots). Typically, dental abutments are designed and manufactured by using 3D intraoral scanning systems and dental CAD software that provide a high degree of customization for optimized abutment design for the specific patient and that generate a customized/optimized digital model that enables the use of CAM systems to manufacture the custom dental abutment. Advantageously, these CAD systems provide for toggling through a range of virtually unlimited positions (via “handles” that be clicked on and moved to manipulate the digital design into any unique desired shape, often amorphic) to produce an optimized abutment design that is truly unique to the specific oral anatomy of the specific patient. However, the 3D intraoral scanning systems tend to be expensive, and the dental CAD software tends to be very expensive and difficult to use. As a result of this, such conventional custom/optimum abutment design capabilities tend to be out of the reach of many dental professionals.
Accordingly, it can be seen that needs exist for dental abutment design systems and methods that can be used by more dental professionals. It is to the provision of solutions meeting these and other needs that the present invention is primarily directed.
Generally, the present invention relates to systems and methods of designing and manufacturing semi-custom dental abutments. In one aspect, an overall design method includes capturing objective oral geometry of a patient's mouth without the need of using 3D scanning equipment, designing a digital model of a semi-custom dental abutment based on the captured data and by using abutment design software that has menus of a small/minimal number of discrete incremented design options such as rotational position, subgingival shape, and overall abutment dimensions, and outputting data representing the digital model design for further processing to manufacture the semi-custom dental abutment.
In another aspect, the invention relates to a method of using a CAM system to manufacture a semi-custom dental abutment based on the data representing the digital model design. And in another aspect, the invention relates to semi-custom dental abutment design software used in the overall dental restoration method.
The specific techniques and structures employed to improve over the drawbacks of the prior systems and accomplish the advantages described herein will become apparent from the following detailed description of example embodiments and the appended drawings and claims.
The present invention may be understood more readily by reference to the following detailed description of example embodiments taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this invention is not limited to the specific devices, methods, conditions, or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed invention. Any and all patents and other publications identified in this specification are incorporated by reference as though fully set forth herein.
Also, as used in the specification including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and reference to a particular numerical value includes at least that particular value, unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” or “approximately” one particular value and/or to “about” or “approximately” another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment.
Generally, an abutment design software system is provided that includes only a small/minimized number of design options such that the produced abutment design is not customized in the sense that is optimized for the specific patient, but rather such that the abutment design is “semi-customized” to be a “good-enough” or “close-enough” approximation of an optimized design to provide only a functionally acceptable (i.e., for fit, comfort, and performance) degree of customization (and not an optimized one) of the resulting physical abutment. This is done by using only a limited/small number design inputs, with each having only a limited/small number of options, with these limited inputs and options limited to discrete increments, with these limited inputs and options readily obtainable by manual measurements (e.g., with a tool and/or by visual estimation), and with these limited inputs and options common to many patients and thus not actually unique to the patient. As such, the term “semi-custom” means limited customization and is thus substantially different from fully customized (i.e., optimized). As a result, the semi-custom abutment design software is less costly and also is easier to use than conventional dental CAD software. Also, the semi-custom abutment design software system requires less in the way of oral geometry data inputs (relative to conventional dental CAD software), so 3D scanners are not needed to obtain the inputs needed to design the semi-custom abutments. At the same time, the semi-custom abutment design software can still be used to generate a data file of a digital abutment model that can be used by conventional CAM systems to manufacture the semi-custom abutment. Because CAM systems can be used that provide a high degree of precision in manufacturing complex shapes, the resulting physical abutment includes only functionally acceptable inaccuracies (relative to an optimized design) because inaccuracies resulting from the approximations in the semi-customized design are not magnified by allowable tolerances in the manufacturing process.
With reference now to the drawing figures, wherein like reference numbers represent corresponding parts throughout the several views,
Referring to
Although 3D scanners are not required for capturing the oral geometry data at step 12, they can be used if desired. As such, the basic discrete measurements for inputting into the abutment design software 50 can be obtained by a dental professional using a conventional 3D scanner, as indicated at 12b. The use of such conventional 3D scanning equipment is well known in the art and so for brevity additional details are not described herein.
As shown in
In addition, in typical embodiments the manual measurements taken include an offset (timing) angle defining the angular orientation (about the implant longitudinal axis) of a feature of the implant 36 for inputting into the semi-custom abutment software 50 for determining the proper angular orientation of the abutment so that the resulting prosthesis is correctly aligned in the dental arch. For example,
Alternatively, the margin widths, the margin heights, and the offset angle α can be manually measured by using a dental ruler/protractor tool, by using another dental tool for taking linear and/or angular measurements, and/or by visual estimation by the dental professional. Also, one of the margin widths can be measured using a dental tool and the other three margin widths estimated based on visual inspection if they are slightly smaller, slightly larger, or substantially the same, and/or one of the margin heights can be measured using a dental tool and the other three margin heights estimated based on visual inspection if they are slightly smaller, slightly larger, or substantially the same. As such, the term “manual measurements,” as used herein in the context of the inexact design of a semi-custom abutment, includes visual estimations, whether made with the aid of a reference tool (e.g., the periodontal probe) or unassisted with only the naked eye.
Referring back to
Generally described, the design method implemented by the abutment design software 50 includes a “setup” step in which a base abutment top portion (the “topcap”) is selected based on the tooth location, an “emergence” step in which a base abutment bottom portion (the “emergence”) is selected based on the clinician's expertise (e.g., preference and/or experience), a “margin” step in which measurements from step 12 are input to semi-customize the abutment bottom portion/emergence, and a “topcap” step in which dimensions (e.g., width and height) and tilt angles (e.g., in two perpendicular planes) are input based on the clinician's expertise to semi-customize the abutment top portion/topcap. In the depicted embodiment, four buttons are screen-displayed for each of these four steps (see, e.g.,
At step 14 of the method, a prosthetic setup process is performed, as shown with reference to the screen displays of
As part of this setup process 14, the user is also presented with an option for selecting an abutment connection size (i.e., platform/connection), for example the connection size buttons 60 shown in
And as another part of this setup process 14, the user can also be presented with an option for selecting an abutment type, for example the abutment type buttons 64-68 shown in
At step 16 of the method 10, the basic measurements from step 12 are input into the abutment design software 50 for semi-customization of the base abutment design 54, for example in sub-processes for designing the abutment emergence, margin, and topcap, as shown with reference to the screen displays of
The software can provide for inputting the offset (timing) angle α at any time in the design process, for example it can be included in the emergence design sub-process of step 16, as depicted, or alternatively in the setup step 14. As such, the user can be presented with an option for entering the offset (timing) angle α measured at step 12, for example as a sliding button 76 as shown in
As part of the emergence design sub-process of step 16, the user can be presented with an option for entering a subgingival “emergence” base (generic) shape from a menu of only a few basic options in keeping with the semi-customization aspect of the software. The base subgingival shape of the abutment design is selected by the dental professional based on the desired end result and the dental professional's expertise (e.g., preference and/or experience). The emergence is the lower portion of the abutment 54 below the topcap, that is, it extends between the connection end of the abutment 54 (closest to the implant connection) and the margin (edge/shoulder) of the abutment 54 where the topcap begins.
In the depicted embodiment, buttons are presented for “straight” 78, “concave” 80, and “convex” 82 emergencies, as shown in
In the margin design sub-process of step 16, the user can be presented with options for entering some or all of the pocket “margin” widths and heights relative to the implant 36 as measured in step 12 above to semi-customize the emergence of the digital abutment 54. Buccal-lingual width and height refer to the pocket margin dimension in the cheek-to-tongue plane for a given tooth position, and mesial-distal width and height are perpendicular to that, as shown and described above with respect to step 12. For example, the user can be presented with sliding buttons for inputting the margin widths and heights (in predefined increments, e.g., 0.1, 0.2, or 0.5 mm) on all four sides (buccal, lingual, mesial, and distal) of the implant 36, thereby providing only a few basic options in keeping with the semi-customization aspect of the software 50, as shown in
As depicted, a button 90 corresponding to the width of the distal margin (WDM from
After this margin sub-process is completed, the previously symmetric base abutment 54 of
In some embodiments, the software 50 can provide for customizing a hybrid interface position of the abutment (see, e.g.,
In addition, some embodiments of the software 50 can provide for customizing an angle of a screw channel formed in the abutment (see, e.g.,
In the topcap design sub-process of step 16, the user can be presented with options for entering some or all of the “topcap” design parameters. Generally speaking, the “topcap” is the top portion of the abutment above the bottom portion (i.e., the emergence) and thus above the abutment margin (i.e., the line) separating (i.e., delineating) the topcap and the emergence. The topcap design parameters can be selected based on the clinician's expertise (e.g., preference and/or experience). For example, the user can be presented with sliding buttons for inputting the width of the abutment shoulder (defining the lateral offset of the abutment margin between the topcap and the emergence) and the overall height of the overall abutment (the topcap and the emergence), as well as the topcap axial angles (relative to the axis defined by the connection) in two perpendicular planes, thereby providing only a few basic options in keeping with the semi-customization aspect of the software 50, as shown in
The shoulder width is selected to provide sufficient thickness for a crown to seat atop the abutment, the overall height is selected based on the patient's oral anatomy, and the buccal-lingual and mesial-distal angles are selected to provide the desired tilt based on the patient's oral anatomy. Thus, the shoulder width effectively defines and can be considered a selection of the topcap width, and this can be selected based on the prosthetic to be used. The emergence height was input in a previous step based on the pocket margin depth/width measurements, and so effectively the current step can be considered to be selecting the topcap height (the difference between the overall height desired and the emergence height on each side of the abutment), but the software can provide for setting the height dimension as described herein for ease of selecting a single input. Also, the overall height selection can be based (at least in part) on an additional manual measurement taken by the clinician (e.g., at step 12) of the height of the adjacent teeth and/or the width of the inter-occlusal space, and not just a visual estimation. Furthermore, the topcap tilt angles can be selected based (at least in part) on additional manual measurements taken by the clinician (e.g., at step 12) of the axial orientation of the implant 36, and not just a visual estimation.
As depicted, a button 106 corresponding to a width of the topcap shoulder can be adjusted (for example, to 0.5 mm, see
The virtual abutment 54 has now been semi-customized sufficiently to provide good fit and comfort for the patient, based only on taking a few measurements and inputting them into the software 50, then making a few component-type selections and a few component-parameter adjustments using the software 50. While not producing the precise and optimized fit of more-complex and difficult-to-use abutment design software systems, this “good-enough” fit is achieved by easy-to-use semi-customizing design software and steps that can be used by many more dental professionals.
More particularly, this software-implemented design method includes semi-custom designing the digital abutment by inputting discrete/incremented values (measurements) to produce a visual screen-displayed digital model of the abutment design providing a close-enough approximation of an optimized abutment design, and does not provide “handles” on the displayed model that permit toggling to adjust the surface in any direction to any position to manipulate the model to produce unique shapes and/or other features customized/optimized for patient-specific anatomy. Additionally, the only visual aids displayed by the software are gross anatomic directions—the software does not store or display any geometry of neighboring or patient-specific anatomy to help in the abutment design process. So the operator can only design the abutment based off of desired dimensions and angles measured (directly or indirectly) from the patient's oral anatomy, because the software provides no visual correspondence to their oral anatomy.
In step 18 of the method 10, the software in some embodiments can provide options for visualization of the semi-customized abutment 54. For example, this step can be initiated by clicking on a respective button (e.g., the “confirm” button of
In various embodiments, as shown for example in
In some embodiments such as that depicted, additional toggle icons/buttons are provided (e.g., to the right of the axes menu across the bottom of the screen). These can include an icon (e.g., compass-looking) for toggling between orientation labels (e.g., identifiers/letters) that provide visual indicators to further clarify directions/surfaces. These can also include an icon (e.g., an eye/slash mark) for toggling between transparent and solid design representations, for example to reveal the presence of the titanium base within hybrid zirconia restorations. And these can further include an icon (e.g., a bullseye) for toggling between displays of the outer limit, the inner limit, and the screw channel. The outer and inner limit can be approximated by cylinders that roughly define the maximum and minimum design constraints (manufacturability or structural considerations, e.g., not manufacturable, too large/cantilevered for safe use clinically, and/or too thin-walled) associated with the abutment. The screw channel gives consideration for the size and location of the thru-hole to be included in the final abutment design for receiving the mounting screw.
Finally, in some embodiments such as that depicted, the visualization screen can display additional view toggles, such as those at the top left of
It should be noted that, while the example semi-custom abutment design software 50 shown and described herein provides design options for a single implant manufacturer and its particular implant geometries, various other related embodiments are contemplated by and included in the scope of the present invention. For example, the semi-custom abutment design software can be provided with design options for a number of different implant manufacturers and their particular implant geometries, provided in an “open to developers” version where additional implant manufacturers can add their implant geometries, or provided in other versions and formats as may be desired and are within the capabilities of persons of ordinary skill in the art.
With particular reference to
In some embodiments, the software 50 generates the STL (or other CAM) file by combining predefined meshes of inalterable areas (e.g., implant connections) with the semi-customized mesh for the alterable regions (e.g., pocket margin heights, shoulder widths). In some embodiments, abutment geometry that is common to many patients can be pre-generated, so once the abutment design is set based on the inputted discrete measurements and type selections, the corresponding abutment design is pulled and immediately available, and in other embodiments all of the abutment geometry can be generated as the design inputs are received. In some embodiments, common abutment designs (or features thereof) are saved for future use, or they can be passed along to a milling center for manufacturing standardized abutments that are commonly ordered. And in some embodiments, the STL (or other CAM) file is generated and downloadable for the user, but then not stored permanently, with the user responsible for self-storage of custom-generated files.
At this point the software 50 enables the user to send an order for fulfillment of the physical abutment 30. This can be done for example by outputting and sending the CAM file to a CAM manufacturer (e.g., a milling center) for fabrication, by providing the fabricator with access to the software for downloading directing, by generating a code that lists the inputted selections and data/measurements and sending the code to the fabricator for it to create the STL file, or by sending the order to another type of fulfillment facility (e.g., a warehouse storing an inventory of CAM-made abutments of commonly used/ordered designs that have been premade and stored until ordered).
In step 22 of the method 10, the CAM file is received by the CAM-equipped fabricator. And in step 24, the physical abutment 30 is manufactured using the CAM equipment based on the CAM file of the digital abutment design 54. The CAM software/equipment (e.g., example types described above) can be of a conventional type that is well-known in the art, so details are understood by persons of ordinary skill in the art and are thus excluded for brevity. As noted above, commonly used/ordered abutment designs can be manufactured and inventoried in advance, and in such cases the physical abutment has already been CAM-fabricated and is in this step merely identified as such and located in the storehouse. For such embodiments, a prior directory (e.g., a database) of common designs can be provided and the design software 50 can run a routine to identify if the newly designed abutment matches one of the common-design abutments.
Finally, in step 26 of the method 10, the physical abutment 30 is received from the CAM fabricator (or other fulfillment facility) and the dental clinician delivers it to the patient.
The abutment design software 50 and the overall dental restoration method 10 thereby provide advantages over the prior art. For example, in example embodiments of the semi-custom design software, the user does not work off of a model input into the software by way of a 3D scan. Instead, the user inputs a discrete number of relatively crude manual measurements (dimensions and angles) and abutment-type selections to determine the basic/essential size of the abutment desired, then inputs those measurements into the software where it is adapted into a visual model and displayed. This is in contrast to conventional customizing/optimizing software and methods, in which the patient (or a model) is scanned, the scan file is input into the CAD software, which is used to locate the implant via an alignment algorithm, and which is then used by manually dragging toggles on the displayed abutment to manipulate it to bring it into a unique size and shape configuration, with a virtually infinite possibility of configuration available for optimizing the abutment. While this may seem somewhat primitive, it has a distinct advantage: the user does not need to have a 3D scanner, expensive dental CAD design software, or a high-end computer to effectively create a functional abutment that can be manufactured using CAD/CAM technology. And while a traditional/non-techy lab can typically cast a custom abutment out of a material like gold/palladium alloys, it is now desirable to make abutments of modern ceramics, titanium, and/or cobalt chrome, which are not so easily processed. Instead, CAM is required to manufacture them, and thus CAD becomes the limiting factor in producing abutments of those materials. The semi-custom abutment design software 50 thereby significantly lowers the barrier to CAD entry.
The semi-custom abutment design software 50 can be downloaded, web-based, stored on a non-transitory storage device (e.g., magnetic and/or optical drive), or provided in other conventional formats. Also, the semi-custom abutment design software 50 can be located remotely and independently in a workflow where the user simply submits measurements on paper for a third-party operation to input into the software (e.g., non-digital users who prefer paper-based prescriptions), provided online where the design feeds an order directly to a milling center, and/or provided in a version where the output (whether online or locally installed) outputs the CAM file to manufacturer. Additionally or as a supplement, the software 50 can be hosted on a website and/or provided as a standalone application (e.g., mobile-optimized) that the user can download and then locally run (without internet access).
As such, the semi-custom abutment design software 50 includes instruction sets (e.g., programmable by coders of ordinary skill in the art) that can be stored on a computer-readable medium of a conventional type (i.e., a non-transitory storage device) and that can be read by a conventional computer processor to implement the functionality described and shown herein. The design software 50 can thus be stored locally on a server or a bank of servers and locally accessed by users via a client/server network (e.g., a LAN), or it can be stored remotely on a server or a bank of servers (e.g., in the cloud or another distributed network) and remotely accessed by users via a large-scale communications network (e.g., the internet or a cellular network). The users (also referred to herein as dental professionals, clinicians, and operators) can thus access and use the design software 50 on conventional connected computer devices (e.g., desktops, laptops, tablets, and smartphones; the software can be optimized for particular uses as may be desired), and as such the design software 50 includes a GUI for interfacing with the screen displays and other input and/or output devices of the connected computer devices (the drawing figures depict representative screen displays provided by the GUI). Also, in some embodiments the design software 50 provides for all outputs (e.g., design/option selections and displayed models) and inputs (measurement data entries) to be via touch-screens of the connected computer devices.
While the invention has been described with reference to example embodiments, it will be understood by those skilled in the art that a variety of modifications, additions, and deletions are within the scope of the invention, as defined by the following claims.
This application claims the priority benefit of U.S. Provisional Patent Application Ser. No. 62/756,192 filed Nov. 6, 2018, the entirety of which is hereby incorporated herein by reference for all purposes.
Number | Date | Country | |
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62756192 | Nov 2018 | US |