Patent Application
20110244429
This application claims priority from GB Application No. 0822751.4, filed Dec. 15, 2008, the disclosure of which is incorporated by reference in its/their entirety herein.
The invention is related to a method of making a dental restoration. In particular the invention concerns a method which includes computer aided design of the dental restoration. Further the invention is directed to a system providing for performing of such method, and which provides for manufacturing of the dental restoration.
Dental restorations or prostheses are often made as a configuration of two or more components, with the individual components providing different characteristics for the restoration. For example, a framework may provide good structural support, and a veneer may provide good aesthetics. The framework generally is a supporting structure for the dental restoration that provides mechanical stability and usually comprises an interface by which the restoration can be affixed to a prepared tooth of a patient. The veneer provides for pleasing aesthetic characteristics so that the restoration resembles a natural tooth in shape and appearance. In addition, both the frame and the veneer are shaped to fit well with the adjacent and opposed teeth in a patient's mouth.
In recent years ceramic materials have been widely used for making high-quality dental restorations because of their good physical, aesthetic and biological properties. In some applications such dental restorations are made by combining a ceramic framework and a ceramic veneer. The framework and the veneer may, for example, be ground or milled from a ceramic blank, or cast from a molten ceramic material. It is desirable that the dental restoration also has an appearance that matches or approximates the appearance of adjacent teeth.
The dental restoration is typically manufactured based on a physical and/or digital replication of the tooth to be restored and adjacent teeth. For example the relevant teeth may be captured physically by a dental impression and/or digitally by scanning the teeth, or a model obtained from the dental impression. A dentist typically provides such physical and/or digital replication to a dental technician who uses that replication to manufacture an appropriate dental restoration. The dental restoration may then be sent to the dentist for implantation in the patient's mouth.
The dental technician is typically provided with all information necessary to complete the dental restoration so that, once such information is obtained from the patient, the dental restoration can be manufactured independently from the patient. Therefore such information typically also includes information about the shape of the tooth prepared to receive the dental restoration, which can be used to finish the dental restoration including an interface for connecting the dental restoration with the prepared tooth.
For example U.S. Pat. No. 6,398,554 discloses a process for the production of a dental prosthesis having a cap for fitting on a human tooth and a crown supported by the cap. The process comprises: taking a digitized three-dimensional image of the tooth; based on the tooth image, defining a digitized internal surface of the prosthesis corresponding to an inner surface of the cap; defining a digitized external surface of the prosthesis, on the basis of environmental parameters of the prosthesis, and taking into account of constraints from the internal surface of the prosthesis; and by use of the internal and external surfaces of the prosthesis, defining an external surface of the cap to form a digitized model of the cap.
US-A-2006/0257824 discloses a method of producing a prosthesis made of a framework as a first component, and a veneer as a second component. The first and second components can be designed by use a CAD system accounting for internal and external surfaces of the prosthesis.
EP application no. 07108206.9 relates to a method of making a veneer for a dental restoration comprising a frame and the veneer. The veneer can be obtained from a veneer precursor made of an open-celled material. An exterior surface of the veneer precursor may be formed based on a virtual model of an exterior surface of the dental restoration. An interior surface of the veneer precursor may be formed based on a virtual model of an exterior surface of a frame. The exterior surface of the dental restoration may be designed on a CAD system by use of surface data obtained from scanning a patient's tooth, scanning a temporary restoration, or scanning a model of a patient's tooth.
There is still a need for a method which provides an efficient workflow for restoring a tooth by use of a separately manufactured dental restoration. It is particularly desirable to minimize and/or efficiently control interactions between the patient, the dentist and the dental technician. A workflow for restoring a tooth should be preferably convenient for the patient. Further such workflow should be time saving and easy to handle for the dentist and the dental technician. It is also desirable to provide a method which provides a precise and optically pleasant dental restoration. Moreover an overall workflow of restoring a tooth and therefore a method of making a dental restoration is preferably relatively inexpensive.
In a first aspect the invention relates to a method of making a dental restoration from a frame and a veneer. The frame and the veneer each have an inner and an outer surface, wherein the inner frame surface corresponds to an inner surface of the dental restoration and the outer veneer surface corresponds to an outer surface of the dental restoration. The inner veneer surface and the outer frame surface are adapted, for example shaped, to be mated with one another to form the dental restoration.
The method comprises the steps of:
The term “surface data” within the scope of this specification relates to data that are adequate to represent a three-dimensional surface. Such surface data may be used in a dental CAD system for designing the dental restoration.
For better understanding only, this specification generally refers to “the tooth” to be restored although the scope of the invention encompasses more than one tooth.
The invention is advantageous in that it may allow for designing at least part of a dental restoration independently from a preparation of a tooth to be restored. The invention may further allow for splitting up the design of the outer and inner shapes of the dental restoration. For example at least part of the exterior shape of the dental restoration may be designed without the availability of the inner shape of the dental restoration that forms the interface to the natural tooth. As an advantage the dental restoration may be at least partially prepared in parallel to the preparation of a patient's tooth. Consequently the time period required for restoration of a patient's tooth may be minimized. A patient may for example need to visit the dentist only a few times, or even once, to obtain a dental restoration of the type described herein. In this way also a temporary restoration of a patient's tooth may be saved, or a temporary restoration having a reduced durability may be sufficient.
As another advantage the shape of the frame may be designed according to an optimized shape of the veneer. For example the frame may be shaped according to minimum and maximum thicknesses of the veneer. Thereby undesirably thin and thick areas in the veneer, and therefore the risk for chipping, may be reduced.
In one embodiment the steps (a) to (d) of the method of the invention are performed in the order (a), (b), (c), and (d).
The prepared natural tooth surface of step (d) may be scan data obtained from scanning the natural tooth to be restored, or a replication of that tooth. A replication may be a negative or positive (physical) model of the tooth. A negative model may be a dental impression, and a positive model may be a plaster model casted from such dental impression, for example. The scan data may be loaded in the CAD system via network or a data carrier, and may be stored on the system for further use.
In step (b) of the method of the invention the outer frame surface may be determined based on the outer veneer surface independent from the inner frame surface. For example the outer frame surface may be determined without the availability or use of the inner frame surface. Thus the shape of the inner frame surface may not be required for this step, as well as the shape of the prepared natural tooth. This may allow the outer frame surface to be determined even at a stage the tooth to be restored is still unprepared.
In step (c) the inner veneer surface may also be determined based on the outer veneer surface. This may be advantageous for designing the veneer according to a minimum and/or a maximum thickness, for example to achieve certain optical and/or stability characteristics. Thus a veneer may be provided with a pleasant appearance, and chipping of the veneer may be prevented.
In one embodiment the method of the invention comprises the step of shaping the outer frame surface and/or the step of shaping the inner veneer surface to account for at least one intermediate layer arranged between the frame and the veneer. The step(s) of shaping the inner veneer surface and/or the outer frame surface is preferably performed using computer-aided design (CAD). The outer frame surface and the inner veneer surface may particularly shaped, such that in the final (physical) dental restoration a space for the intermediate layer is provided. The intermediate layer in the final dental restoration may be a bonding layer interconnecting the frame and the veneer. Such an intermediate layer may further comprise colorants to provide the dental restoration with a certain color, or to trim the color(s) of the veneer and/or the frame toward another color. More than one intermediate layers are possible, for example differently colored layers. The intermediate layer(s) may thus provide for a good durability and a pleasant optical appearance of the dental restoration.
In another embodiment the method of the invention, comprises the step of providing the veneer with an inner surface that is proportionally scaled relative to the outer frame surface. Further the method may comprise the step of providing the frame with an outer surface that is proportionally scaled relative to the inner veneer surface. Thus the inner veneer surface and the outer frame surface may be proportionally scaled with respect to one another. Therefore the intermediate layer may have a generally uniform thickness. This may provide for a uniform color of the final dental restoration.
The term “proportionally scaled” within the context of this specification means that each of the three dimensions of a scaled object is enlarged or reduced relative to the corresponding dimension of the original object by preferably substantially the same magnification or reduction factor. Further, “proportionally scaled” may include tolerances of the magnification or reduction factor in each dimension so that each of the three dimensions of the scaled object may be scaled relative to the corresponding dimension of the original object by three individual factors being different from each other by 1% to 5%. Instead proportionally scaling a surface may also be generated from an offset of another surface. For example the inner veneer surface may be obtained from an offset of the outer frame surface, or vice versa.
In one embodiment the method of the invention, comprises the step of shaping the inner frame surface to account for at least one fixation layer for connecting the frame and the prepared natural tooth. Thereby the frame may be adapted for mating with the prepared natural tooth surface with the fixation layer arranged between. The step of shaping the inner frame surface is preferably performed using computer-aided design (CAD). The fixation layer of the final dental restoration may be adapted for securing the frame (or the dental restoration) on the natural tooth. A material as it may be used for providing a fixation layer is for example RelyX™ Unicem, as available from 3M ESPE AG, Germany.
The method of the invention may further comprise the step of providing the frame with an inner surface that is proportionally scaled relative to the prepared natural tooth surface. Therefore the fixation layer may obtain a generally uniform thickness. This may provide good durability of the bond between the frame (or the dental restoration) and the natural tooth. The method of the invention however may also comprise the step of providing the frame with an offset of the outer surface of the prepared natural tooth.
In one embodiment of the invention step (a) comprises the steps of:
The predefined standard tooth surface may be provided by a database holding a plurality of standard tooth surfaces. Such standard tooth surfaces may be scaled and/or reshaped according to conditions and/or limitations resulting from teeth that surround the tooth to be restored. For example, a standard tooth surface may be obtained from the database and resized to fit with teeth that surround the tooth to be restored. Further the standard tooth surface may be locally deformed to avoid collisions with such surrounding teeth. Thus the outer veneer surface may be determined automatically to a relatively large extent, and manually adapted further. Therefore efforts for manual adaptations may be reduced.
The option to manually modify the standard tooth surface may comprise features for changing the position, the shape and/or the orientation of the standard tooth surface. Examples of such features are dragging, stretching, compressing, rotating, of the standard tooth surface or portions of it. The option to manually modify the standard tooth surface is preferably software implemented and provided on the CAD system. Preferably the predefined standard tooth surface, in the initial and in modified stages, is displayed by the CAD system. Further the tooth to be restored, and optionally the surrounding teeth, may be displayed on the system. Thus a user may modify the predefined standard tooth surface to match the tooth to be restored as well as the surrounding teeth by aid of the display of the CAD system.
The CAD system may provide a feature allowing the user to accept the initial or modified standard tooth surface as the outer veneer surface (or the outer surface of the dental restoration), for example, when the user is satisfied with the shape of the tooth surface.
In another embodiment of the invention the method, comprises the step of scanning of the natural tooth (or a replication of the tooth) to provide the prepared natural tooth surface in the form of surface data. The method may further comprise the step of scanning surrounding teeth to provide ancillary data. Such ancillary data may be used as reference in the design of the dental restoration.
In another embodiment of the invention the method comprises the step of automatically detecting a preparation margin of the prepared tooth. The method may further comprise the step of providing an option to manually modify the detected preparation margin. The preparation margin, typically representing an important limitation in the design of the dental restoration, thus may be determined mainly automatically, and adapted manually after. Therefore the determination of preparation margin may be performed relatively rapidly, and further relatively precisely.
In another embodiment of the invention the method comprises the step of evaluating a possible direction of assembly of the frame onto the prepared natural tooth, and determination of an assembly axis A aligned with that direction. In a further embodiment of the invention the method comprises the step of evaluating a possible direction of assembly of the veneer onto the frame, and determination of an assembly axis B aligned with that direction. This may allow for optimization of the wall thicknesses of the frame and the veneer, for example, because cutaways at the frame and/or the veneer that may be needed to avoid collisions during assembly of the veneer and the frame may be minimized.
In one embodiment of the invention the method comprises the step of selecting the predefined standard tooth surface from the database, based on at least one of the preparation margin, the ancillary data, and user inputs. For example a user may input a tooth position relative to other teeth in a patient's mouth in a CAD system, and the CAD system may automatically select a suitable standard tooth surface from the database. The CAD system may further use the preparation margin and/or the ancillary data for this selection. Thus a standard tooth surface may be provided which largely matches the desired shape of the dental restoration. This may save a user time in the design of the dental restoration.
In another embodiment of the invention the method comprises the step of providing an option to enter a thickness of an intermediate layer between the veneer and the frame. In a further embodiment of the invention the method comprises the step of providing an option to enter a fixation layer between the frame and the prepared natural tooth. For example a user may input the intermediate layer thickness and/or the fixation layer thickness into the CAD system, and the system may automatically calculate the frame and veneer surfaces appropriately. This may provide a rapid and precise design of the dental restoration.
In a further embodiment of the invention the method comprises the step of performing a collision analysis for an assembly of the frame onto the natural tooth along the assembly axis A. In another embodiment of the invention the method comprises the step of performing a collision analysis for an assembly of the veneer onto the frame along the assembly axis B. The result of the collision analyses may be used to remove portions from the frame and/or veneer which potentially collide when the frame and the veneer are assembled. Thus it may be ensured that the veneer and the frame can be assembled as well as the frame can be assembled on the prepared tooth without damaging the veneer and/or the frame. Costs for modifications of the dental restoration, or for manufacturing a new dental restoration may therefore also be avoided. The collision analyses for the assembly of the frame onto the natural tooth or for the assembly of the frame and the veneer may also be based on precursors of the frame and/or the veneer. In particular the collision analysis may be based on the assembly of the frame and a veneer precursor, latter being scaled (for example enlarged) relative to the final veneer.
In another embodiment of the invention the method comprises the step of scaling the inner and outer frame surfaces, and at least the outer veneer surface. This may be useful to account for a change in size that may occur during the manufacturing of the frame and/or the veneer. For example the frame and/or the veneer may be shaped (for example machined) from a pre-sintered material which is sintered finally and thereby shrinks. To account for such shrinkage the frame and/or veneer may be (proportionally) enlarged, so the frame and/or the veneer obtain(s) their final shape during sintering.
In one embodiment the method of the invention comprises the step of machining a frame precursor. Further the method of the invention may comprise the step of machining a veneer precursor. The frame precursor and the veneer precursor may be proportionally scaled relative to the frame and the veneer. The method of the invention may comprise the step of sintering of the frame precursor to provide a frame. Sintering may cause the frame precursor to shrink, so that the frame obtains its final size. In a preferred embodiment the method further comprises the steps of providing a slurry comprising a glass ceramic material, and combining the veneer precursor and the frame with the slurry in between. Thereby a dental restoration precursor may be provided. The method of the invention further preferably comprises the step of sintering the dental restoration precursor to provide the dental restoration. During this step also the veneer may shrink and thereby obtain its final size.
A frame or frame precursor may be made of a ceramic material. For example, one comprising between 90% and 99% by weight zirconium oxide, and preferably between 91% and 97.25% by weight zirconium oxide. The ceramic material of the frame may further comprise 0% to 1% by weight aluminium oxide. The ceramic material may also be based on aluminium oxide, in which case it may comprise 90% to 99% by weight aluminium oxide and 0% to 1% by weight zirconium oxide. Further the ceramic material may generally comprise 0% to 10% by weight of at least one of hafnium oxide, yttrium oxide and oxides from gallium, germanium, and indium. The ceramic material may also comprise 0.0005% to 1.5% by weight of coloring additives, selected from the group consisting of the oxides Fe2O3, Er2O3 and/or MnO2. The ceramic material is preferably selected to be compatible for use in human bodies
A frame or frame precursor may further be made of metal. Such a metallic frame may, for example, be manufactured by the “lost wax” method which is known to the person skilled in the art. Thus, the metallic frame may be casted from metal or a metal alloy, or may be machined from a blank of metal or metal alloy.
The metallic frame may be characterized by at least one of the following features:
The metallic frame may be comprised of or may consist of a pure metal only or of a metal alloy. Commercially available metal alloys which were found to be useful for the present invention include for example those described in Table 1 below.
A veneer or veneer precursor may be made of a glass ceramic material. An exemplary formulation of a glass ceramic as it may be used with the present invention comprises 60% to 70% by weight of silica, 9% to 13% by weight of alumina, 5% to 10% by weight of potassium-oxide, 9% to 13% by weight of sodium-oxide, 0% to 1% by weight of lithium-oxide, 2% to 5% by weight of calcia, 1% to 2% by weight of barium-oxide, 0% to 1% by weight of zirconium oxide and 0% to 1% cerium-oxide or cerium-fluoride.
The frame precursor may be made of a pre-sintered ceramic material, and the veneer precursor may be made of a pre-sintered glass-ceramic material. Further the frame may be made of a sintered ceramic material, and the veneer precursor may be made of a sintered material. The sintered material referred to in this specification preferably has a material density in a range of 2 g/cm3 to 2.7 g/cm3, and the pre-sintered material preferably has a material density in a range of 30% to 92% of the material density of the sintered material. Preferably the material density of the pre-sintered material is in a range of 40% to 60% of the material density of the sintered material, and more preferably in a range of 45% to 55%.
The frame and/or the veneer may however also be obtained by first providing a wax model, using the wax model to make a mold, and using the mold to cast the frame and/or the veneer. Instead of wax other suitable materials may be used, including materials allowing the model to be made by rapid prototyping.
In particular, the veneer referred to in this specification preferably has a material density in a range of 2 g/cm3 to 2.7 g/cm3, and the veneer precursor preferably has a material density in a range of 30% to 92% of the material density of the veneer. Preferably the material density of the veneer precursor is in a range of 40% to 60% of the material density of the veneer, and more preferably in a range of 45% to 55%.
For example, the material density of the veneer precursor (or the pre-sintered material) may be in a range of 0.6 g/cm3 to 1.84 g/cm3 and the veneer (or the sintered material) obtained from it may have a material density of about 2 g/cm3. In another example the material density of the veneer precursor (or the pre-sintered material) may be in a range of 0.81 g/cm3 to 2.5 g/cm3 and the veneer (or the sintered material) obtained from it may have a material density of about 2.7 g/cm3. The veneer precursor (or the pre-sintered material) may generally have a material density in a range of 0.6 g/cm3 to 2.5 g/cm3.
Typically the difference between the density of the veneer precursor and the density of the veneer (or the pre-sintered material and the sintered material, respectively) is a result of the presence of a higher amount of cells within the veneer precursor (or the pre-sintered material) than in the veneer (the sintered material).
The average size of the particles forming the pre-sintered material as referred to in this specification is typically in a range of about 10 μm to about 60 μm, and preferably about 30 μm. The distribution of the particle size may be for example:
In more particular the average particle size which the pre-sintered material referred to in this specification is comprised of may be about 20 μm, for example according to a particle size distribution in which:
The volume of the cells in the pre-sintered material relative to the total volume of the pre-sintered material as referred to in this specification is typically in a range of about 20% to about 40%, and more preferably in a range of about 30% to about 38%.
The slurry may comprise a powdery glass ceramic material, for example of the type used for the veneer or veneer precursor. The slurry may further comprise water, and optionally colorants.
A second aspect of the invention is directed to a computer system configured to perform the method of the invention. The computer system may comprise or be connectable to a database holding a plurality of standard tooth surfaces. The computer system further may be connectable to a scanner for scanning teeth in a patient's mouth (intra-oral scanner), or to a scanner for scanning a replication of a patient's teeth. Further, the computer system may be connectable to a machine for machining dental parts, particularly to a milling and/or grinding machine for machining a frame and/or a veneer and/or precursors thereof. Further a rapid prototyping machine may be used. The computer system may comprise a remote connectivity with at least one of the scanner, the machine and the database. In this regard a remote connection may be, for example, comprise an Internet-based connection. The computer system of the invention may therefore provide for performing one or more of the method steps of the invention in parallel, and thus contribute and/or enable for the advantages of the invention.
The following Figures illustrate an exemplary workflow according to an embodiment of the method of the invention. The workflow is preferably performed on a computer system, unless indicated otherwise.
In the example shown the tooth 10 is already prepared to receive the dental restoration, however, in other embodiments the tooth to be restored at this stage may still be unprepared or only partially prepared. A partial preparation may essentially only include a determination of the preparation margin (transition between prepared tooth structure and natural tooth structure). Therefore at the stage of capturing the patient's teeth a patient may not need to be treated with anesthesia. Further, a temporary restoration for protecting the prepared tooth may not be necessary.
As shown in
The frame precursor may be sintered to obtain the frame. The veneer precursor and the (sintered) frame may be assembled with an intermediate layer disposed in between so that a dental restoration precursor is formed. The dental restoration precursor may then be sintered to obtain the final dental restoration.
The invention has now been described by way of several examples. However, people of ordinary skill in the art will understand that various changes and substitutions can be made without departing from the scope of the invention.
| Number | Date | Country | Kind |
|---|---|---|---|
| 0822751.4 | Dec 2008 | GB | national |
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/US09/66167 | 12/1/2009 | WO | 00 | 6/14/2011 |
