Patent Application
20250073010
A broad object of a particular embodiment of the invention can be to provide a method of determining the periodontal pocket depth around a tooth, including: locating the alveolar bone crest of the alveolar bone which supports the tooth to determine an alveolar bone crest location; locating the line where the free gingiva meets the exposed part of the tooth to determine a gumline location; and calculating the periodontal pocket depth using the alveolar bone crest location, the gumline location, and a predetermined biologic width value.
Another broad object of a particular embodiment of the invention can be to provide a program code executable to calculate the periodontal pocket depth from an alveolar bone crest location, a gumline location, and a predetermined biologic width value.
Naturally, further objects of the invention are disclosed throughout other areas of the specification, drawings, images, and claims.
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Notably, conventional periodontal probing can be time-consuming and/or uncomfortable for the patient. Additionally, conventional periodontal probing can be inaccurate, due to both intra-examiner and inter-examiner variability which may result from several factors, including variations in probing force (van der Velden U, de Vries J H. The influence of probing force on the reproducibility of pocket depth measurements. J Clin Periodontol. 1980 October; 7 (5): 414-20), angle/position/tooth location (Fowler C, Garrett S, Crigger M, Egelberg J. Histologic probe position in treated and untreated human periodontal tissues. J Clin Periodontol. 1982 September; 9 (5): 373-85), amount of inflammation present (Armitage G C, Svanberg G K, Löe H. Microscopic evaluation of clinical measurements of connective tissue attachment levels. J Clin Periodontol. 1977 August; 4 (3): 173-90), and periodontal probe design/type (Van der Zee E, Davies E H, Newman H N. Marking width, calibration from tip and tine diameter of periodontal probes. J Clin Periodontol. 1991 August; 18 (7): 516-20).
As an answer to the drawbacks and/or shortcomings of conventional periodontal probing, disclosed herein is an alternative thereto which allows the periodontal pocket depth (15) around a tooth (1) (whether natural, real, artificial, fake, prosthetic, a dental implant, etc.) to be determined without the use of a periodontal probe (13), whereby the present method includes locating the alveolar bone crest (9) of the alveolar bone (4) which supports the tooth (1) to determine an alveolar bone crest location (17) (or level); locating the line where the free gingiva (11) meets the exposed part of the tooth (1) to determine a gumline location (18) (or level); and calculating the periodontal pocket depth (15) using the alveolar bone crest location (17), the gumline location (18), and a predetermined biologic width (10) value. Following the determination of the periodontal pocket depth (15) around each tooth (1) in a patient's mouth, a complete “virtual” periodontal chart can be generated. Advantageously, this “virtual periodontal charting” method can be relatively quick, efficient, and minimally invasive, particularly in relation to conventional periodontal probing. Further, the inventive method may “standardize” periodontal pocket depth (15) determination, which may correspondingly improve accuracy and reduce error(s) relative to conventional periodontal probing.
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Subsequently, the stitched image (21) can provide (i) the alveolar bone crest location (17) for one or more teeth (1) and (ii) the gumline location (18) of said one or more teeth (1). Thus, the distance (22) or spatial relationship between the two (17) (18) can be determined, such as via measuring.
As per the present invention, the method of determining the periodontal pocket depth (15) around a tooth (1) further includes calculating the periodontal pocket depth (15) using the alveolar bone crest location (17), the gumline location (18), and a predetermined biologic width (10) value, whereby as used herein, the term “predetermined” can mean decided in advance. As described above, the biologic width (10), which provides the natural seal that develops around a tooth (1), is the combined height of the junctional epithelium (7) and the connective tissue (8). Numerous studies which are found in the published literature have measured biologic width (10), with a few examples as follows.
Gargiulo et al. obtained measurements from human autopsy specimens and in particular, 287 individual teeth and their respective dentogingival components from 30 jaws. He concludes that “there is a somewhat definite proportional dimensional relation between the dentogingival junction and the other supporting tissues of the tooth,” finding that the average biologic width (10) is 2.04 millimeters (mm), from a combined 0.97 mm of junctional epithelium (7) and 1.07 mm of connective tissue (8), and the average depth of the gingival sulcus (12) is 0.69 mm. Of note, Gargiulo et al. found that the connective tissue (8) measurement is the most constant, and the junctional epithelium (7) measurement is the most variable.
Vacek et al. examined the naturally occurring dimensions of the dentogingival junction in ten adult human cadaver jaws and found that the mean biologic width (10) is 1.91 mm, from a combined 1.14±0.49 mm of junctional epithelium (7) and 0.77±0.32 mm of connective tissue (8), and the average depth of the gingival sulcus (12) is 1.34±0.84 mm (Vacek J S, Gher M E, Assad D A, Richardson A C, Giambarresi L I. The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent. 1994 April; 14 (2): 154-65). Vacek et al. also found that (i) there were no significant differences in the biologic width (10) measurements between the buccal, lingual, mesial, and distal tooth surfaces, (ii) the posterior teeth showed a significantly greater (P<0.004) biologic width (10) than the anterior teeth, and (iii) there was no correlation between loss of attachment (the distance from the cementoenamel junction to the most coronal extent of the connective tissue (8)) and biologic width (10).
Schmidt et al. found that the mean values of the biologic width (10) obtained from two meta-analyses ranged from 2.15 to 2.30 mm (Schmidt J C, Sahrmann P, Weiger R, Schmidlin P R, Walter C. Biologic width dimensions—a systematic review. J Clin Periodontol. 2013 May; 40 (5): 493-504).
It is herein noted that the above three studies are exemplary only, and any predetermined biologic width (10) value, such as from the published literature which provides biologic width (10) data, can be used with the present invention.
As to particular embodiments, to calculate the periodontal pocket depth (15) for a tooth (1), the predetermined biologic width (10) value can be subtracted from the distance (22) between the alveolar bone crest location (17) and the gumline location (18) obtained from the stitched image (21) of said tooth (1). Now, referring primarily to
As to particular embodiments, the present invention can further include a program code and/or application and/or software (such as is contained in a non-transitory computer readable medium communicatively coupled to a processor) executable to select a tooth (1) in a plurality of scanned teeth (1), determine the alveolar bone crest location (17) for the selected tooth (1) (such as from a stitched image (21) of said tooth (1)), determine the gumline location (18) for the selected tooth (1) (such as from the stitched image (21) of said tooth (1)), determine the distance (22) between the alveolar bone crest location (17) and the gumline location (18) (such as from the stitched image (21) for the selected tooth (1)), and generate a periodontal pocket depth (15) for the selected tooth (1) using a predetermined biologic width (10) value. Generating the periodontal pocket depth (15) can include calculating, such as with the use of an algorithm, the periodontal pocket depth (15) using the predetermined biologic width (10) value. Calculating the periodontal pocket depth (15) can include subtracting the predetermined biologic width (10) value from the distance (22) between the alveolar bone crest location (17) and the gumline location (18).
As to particular embodiments, the program code can further be executable to record the periodontal pocket depth (15) for the selected tooth (1).
As to particular embodiments, the program code can further be executable to display on a display surface the periodontal pocket depth (15) for the selected tooth (1), such as in measurement units.
As to particular embodiments, the program code can further be executable to identify a selected tooth (1) by its location, such as by its number (for example, 3, 11, 26, etc.) and/or name (for example, first molar, cuspid, lateral incisor, etc.).
As to particular embodiments, the program code can further be executable to associate a specific predetermined biologic width (10) value with an identified tooth (1) based on its location. For example, as derived from Vacek et al., a biologic width (10) value of about 1.75 mm can be associated with a tooth (1) identified as anterior, and a biologic width (10) value of about 2.08 mm can be associated with a tooth (1) identified as a molar.
As to particular embodiments, the program code can further be executable to determine the periodontal health of a patient and specifically, whether the periodontal pocket depth (15) generated for a selected tooth (1) is considered (i) normal/healthy, (ii) indicative of mild periodontitis, (iii) indicative of moderate periodontitis, or (iv) indicative of advanced periodontitis.
As to particular embodiments, the program code can further be executable to flag a generated periodontal pocket depth (15) that is considered (i) indicative of mild periodontitis, (ii) indicative of moderate periodontitis, or (iii) indicative of advanced periodontitis.
As to particular embodiments, the program code can further be executable to suggest a treatment plan for a generated periodontal pocket depth (15) that is considered (i) indicative of mild periodontitis, (ii) indicative of moderate periodontitis, or (iii) indicative of advanced periodontitis.
As to particular embodiments, the program code can further be executable to stitch the CBCT data (19) and the digital impression data (20).
As to particular embodiments, the program code can further be executable to receive CBCT data (19) from a CBCT system, and receive digital impression data (20) from an intraoral scanner.
As can be easily understood from the foregoing, the basic concepts of the present invention may be embodied in a variety of ways. The invention involves numerous and varied embodiments of a method for determining a periodontal pocket depth of a tooth and executable programs for such a method.
As such, the particular embodiments or elements of the invention disclosed by the description or shown in the figures or tables accompanying this application are not intended to be limiting, but rather exemplary of the numerous and varied embodiments generically encompassed by the invention or equivalents encompassed with respect to any particular element thereof. In addition, the specific description of a single embodiment or element of the invention may not explicitly describe all embodiments or elements possible; many alternatives are implicitly disclosed by the description and figures.
It should be understood that each element of an apparatus or each step of a method may be described by an apparatus term or method term. Such terms can be substituted where desired to make explicit the implicitly broad coverage to which this invention is entitled. As but one example, it should be understood that all steps of a method may be disclosed as an action, a means for taking that action, or as an element which causes that action. Similarly, each element of an apparatus may be disclosed as the physical element or the action which that physical element facilitates. As but one example, the disclosure of a “location” should be understood to encompass disclosure of the act of “locating”—whether explicitly discussed or not—and, conversely, were there effectively disclosure of the act of “locating,” such a disclosure should be understood to encompass disclosure of a “locator” and even a “means for locating.” Such alternative terms for each element or step are to be understood to be explicitly included in the description.
In addition, as to each term used it should be understood that unless its utilization in this application is inconsistent with such interpretation, common dictionary definitions should be understood to be included in the description for each term as contained in the Random House Webster's Unabridged Dictionary, second edition, each definition hereby incorporated by reference.
All numeric values herein are assumed to be modified by the term “about”, whether or not explicitly indicated. For the purposes of the present invention, ranges may be expressed as from “about” one particular value to “about” another particular value. When such a range is expressed, another embodiment includes from the one particular value to the other particular value. The recitation of numerical ranges by endpoints includes all the numeric values subsumed within that range. A numerical range of one to five includes for example the numeric values 1, 1.5, 2, 2.75, 3, 3.80, 4, 5, and so forth. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. When a value is expressed as an approximation by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. The term “about” generally refers to a range of numeric values that one of skill in the art would consider equivalent to the recited numeric value or having the same function or result. Similarly, the antecedent “substantially” means largely, but not wholly, the same form, manner or degree and the particular element will have a range of configurations as a person of ordinary skill in the art would consider as having the same function or result. When a particular element is expressed as an approximation by use of the antecedent “substantially,” it will be understood that the particular element forms another embodiment.
Moreover, for the purposes of the present invention, the term “a” or “an” entity refers to one or more of that entity unless otherwise limited. As such, the terms “a” or “an”, “one or more” and “at least one” can be used interchangeably herein.
Thus, the applicant(s) should be understood to claim at least: i) each of the methods for determining a periodontal pocket depth of a tooth and executable programs for such a method herein disclosed and described, ii) the related methods disclosed and described, iii) similar, equivalent, and even implicit variations of each of these devices and methods, iv) those alternative embodiments which accomplish each of the functions shown, disclosed, or described, v) those alternative designs and methods which accomplish each of the functions shown as are implicit to accomplish that which is disclosed and described, vi) each feature, component, and step shown as separate and independent inventions, vii) the applications enhanced by the various systems or components disclosed, viii) the resulting products produced by such systems or components, ix) methods and apparatuses substantially as described hereinbefore and with reference to any of the accompanying examples, x) the various combinations and permutations of each of the previous elements disclosed.
The background section of this patent application, if any, provides a statement of the field of endeavor to which the invention pertains. This section may also incorporate or contain paraphrasing of certain United States patents, patent applications, publications, or subject matter of the claimed invention useful in relating information, problems, or concerns about the state of technology to which the invention is drawn toward. It is not intended that any United States patent, patent application, publication, statement or other information cited or incorporated herein be interpreted, construed or deemed to be admitted as prior art with respect to the invention.
The claims set forth in this specification, if any, are hereby incorporated by reference as part of this description of the invention, and the applicant expressly reserves the right to use all of or a portion of such incorporated content of such claims as additional description to support any of or all of the claims or any element or component thereof, and the applicant further expressly reserves the right to move any portion of or all of the incorporated content of such claims or any element or component thereof from the description into the claims or vice-versa as necessary to define the matter for which protection is sought by this application or by any subsequent application or continuation, division, or continuation-in-part application thereof, or to obtain any benefit of, reduction in fees pursuant to, or to comply with the patent laws, rules, or regulations of any country or treaty, and such content incorporated by reference shall survive during the entire pendency of this application including any subsequent continuation, division, or continuation-in-part application thereof or any reissue or extension thereon.
Additionally, the claims set forth in this specification, if any, are further intended to describe the metes and bounds of a limited number of the preferred embodiments of the invention and are not to be construed as the broadest embodiment of the invention or a complete listing of embodiments of the invention that may be claimed. The applicant does not waive any right to develop further claims based upon the description set forth above as a part of any continuation, division, or continuation-in-part, or similar application.
| Number | Date | Country | |
|---|---|---|---|
| 63536847 | Sep 2023 | US |
