A presently proposed embodiment of a system and an arrangement according to the invention will be described below with reference to the attached drawings, in which
FIG. 1 shows, in block diagram form, the equipment and parties involved,
FIG. 2 shows, in side views and horizontal views, and enlarged in relation to FIG. 1, parts of the function chain according to FIG. 1,
FIG. 3 shows, in vertical section, two different embodiments of sleeves used in the template,
FIG. 4 shows, in vertical section, application of a sleeve in relation to an implant, and a fastening screw for the sleeve and the implant,
FIG. 5 shows, from underneath, a model of an upper jaw in which implants are applied with associated anchoring tubes and anchoring pins which extend horizontally in the dentine between the implants,
FIG. 6 shows a top view of the model according to FIG. 5, and
FIG. 7 shows a perspective view, from the side, of orientations for implants and anchoring pins in an upper jaw.
A template can be built up on computer using CAD by modifying the scanned patient prosthesis. In this way, it is possible to avoid the problem of having to produce the template at a dental laboratory, and this is an advantage since the template there is made of acrylic or of a plastic which has a certain shrinkage tendency, with deterioration of the precision as a consequence. According to the invention, the template can be mounted in the articulator with the aid of a bite index. In this way, it is possible to solve the problem of recording the bite relationships of the jaws. The template is used by the surgeon and solves the problem of placing the implant at the planned site in the patient's mouth. The template has an arrangement for its anchoring with anchoring pins which are inserted from the side between the planned implants. In this way, the template is held in place in the mouth with the aid of a bite index which is produced by the dental technician in the articulator. This solves the problem of obtaining the correct bite relationship between the dental bridge and the opposite jaw after the operation. The template contains all data for planning, so that it is not necessary to produce the bone part of the patient's jaw. This reduces the production time and costs in the stereolithography machine. The source of error in the form of having to place the prosthesis model in the correct relationship to the bone part is eliminated.
In FIG. 1, a first party is indicated symbolically by 1, a second party by 2, and a third party by 3. The first party can be a surgeon, dentist, etc., who is to test and fit a dental bridge on a patient 4. The second party can be an owner of a stereolithography machine. The third party can be a dental technician. FIG. 1 also indicates a fourth party represented by a fully automatic production system for dental products; in the illustrative embodiment the party 5 is designated as PROCERA®. The first party has access to identification equipment 6. In addition, the first party has access to a computer appliance 7. The stereolithography machine is symbolized by 8. The dental technician has access to equipment for production of a physical template 9, and equipment 10 for production of a working model in cooperation with an articulator function. In addition, the dental technician produces the final dental bridge in equipment 11.
The identification equipment 6 can be of a type known per se. Thus, for example, the party 1 can produce an impression in a manner known per se using conventional means. Alternatively, cameras, laser equipment, etc., can be used. The computer appliance 7 comprises, in a manner known per se, a computer screen 7a and an operating element 7b which can consist of a keyboard, voice communication unit, etc.. Depending on the identification, the relevant jaw/jaw bone, in this case upper jaw, of the patient 4 can be indicated. The upper jaw structure is symbolized by 7c. In addition, the first party can modify the jaw bone structure on the screen and build up a dental crown structure applied on the jaw bone. Such a structure is indicated by 7d. For the sake of clarity, the upper jaw 7c and the complete structure 7d have been shown as two simultaneous representations. Said representations can of course be indicated one at a time. In the representation 7d, the orientations for the implants and their directions are shown by 7e. The computer appliance can operate with conventional programs (CAD programs), which are available on the market, and file management systems. The stereolithography machine can be of a type known per se and will therefore not be described in detail here.
The scanning equipment 6 provides the computer appliance with first information 12 which represents the scanned jaw bone structure. This is exported to the computer appliance. In turn, the computer appliance generates a CAD file which is represented by 13 in FIG. 1. The CAD file is received by the stereolithography machine which sets the conditions for a physical model transferred to the dental technician 9 for application of sleeves, inter alia. This transfer is represented by 14. The physical model is shown by 15. The dental technician uses the model 15 for production of a working model 16, and the transfer function between the units 9 and 10 is symbolized by 17. The production of the working model takes place in conjunction with an articulator function which is represented by 18. The bite index for the articulator function can be transferred from the patient 4, the computer appliance 7 and/or the identification equipment 6. Said transfers are represented by 19, 20 and 21. At entry to the articulator function, the bite index transfer has been symbolized by 22.
The real dental bridge 23 is produced in the equipment 11 by the party 3. From the equipment 9, the physical template 15 can be transferred to the surgeon or equivalent. This transfer is represented by 24. The party 1 can also have access to equipment symbolized by 1A. This equipment can consist of drilling equipment and insertion equipment for fitting the template and dental bridge on the patient 4. The finished dental bridge can be transferred to the first party, as has been represented by the transfer arrow 26. Formation of holes in the patient's jaw bone with the aid of the template and insertion of the finished dental bridge can take place in a manner known per se and will therefore not be described in detail here.
In accordance with FIG. 1, the fourth party 5 can provide a support function or production of one or more of said function steps. This is shown in the figure where the automatic system comprises adaptation units 27, 28, 29 and 30. The equipment of the other parties can also be connected via adaptation units 31, 32, 33, 34, 35, 36, 37 and 38. The transfers can take place via general communication means 39, for example the telecommunications network, Internet, computer network, etc. The transfer functions are represented by two-direction arrows, which indicates that two-way communications exist. The arrows are represented by 40.
In FIG. 2, an upper jaw of a patient is indicated by 41 and a lower jaw by 42. In the upper jaw, the party 1 has inserted implants 43 in which a dental bridge is to be secured. A set of teeth in the patient's lower jaw is indicated by 44 and, in accordance with what has been explained above, the bite relationship between the dental bridge to be implanted and the teeth of the lower jaw has been effected with the aid of a bite index. Reference number 45 indicates a template in accordance with the above. The template comprises, inter alia, recesses 46 for sleeves 47 used as guide members for formation of holes 48 in which the implants 43 are to be screwed or recessed. Reference number 49 indicates the finished dental bridge structure to be anchored on the implants 43 in the upper jaw. The upper jaw is also shown diagrammatically from underneath by reference number 50 in order to indicate orientations for anchoring pins 51 which extend substantially in a horizontal plane in the jaw structure. FIG. 3 shows a first embodiment of a sleeve 52 which is used for guiding a drill 53 for forming the implant hole 48. The sleeve has a stop edge 52a which can cooperate with the template 54 via a stop surface 54a on the latter. FIG. 3 also shows a second embodiment 55 of a sleeve 56 which is provided with slits 56a. The template 57 in this case has an internal recess 57a into which a snap-fit flange 56b on the sleeve can snap when the sleeve assumes its final position in the template 57. A click noise function can be provided.
FIG. 4 shows an implant 60 applied in a jaw bone and dentine 59. The implant can cooperate with an attachment part 61 over which a sleeve 62 in accordance with the above can be engaged. The components can be held together with a retaining screw 63. The sleeve 62 is mounted in the template or dental bridge part which is indicated by 64. The parts are shown in the disassembled state for the sake of clarity. The parts can be joined together in the direction of the arrow 65. A through-hole in the template 64 is shown by 64a. Cement which is used for securing the sleeve to the template is shown symbolically by 52b.
A structural configuration of a physical template is indicated by 66. In the present case, implants 67 are screwed securely to the template, compare with FIG. 4. The pins for anchoring are shown by 68. FIG. 6 shows the template according to FIG. 5 from underneath. The anchoring pins 68 are designed with manual actuating members by means of which the pins can be screwed through the jaw bone in question. The figure shows that the anchoring pins extend between the implants 67.
FIG. 7 shows, from the side and in perspective, the template according to FIGS. 5 and 6 applied to a jaw bone 69.
The invention is not limited to the embodiment described above by way of example, and instead it can be modified within the scope of the attached patent claims and the inventive concept
Patent Application
20080038692
