CN111166507A

CN111166507A - Personalized tooth preparation step-by-step indication guide plate designed and manufactured in digital mode

Info

Publication number: CN111166507A
Application number: CN201811343388.XA
Authority: CN
Inventors: 刘云松; 周永胜; 刘雪楠; 唐琳; 吴为良; 王时敏
Original assignee: Peking University School of Stomatology
Current assignee: Peking University School of Stomatology
Priority date: 2018-11-09
Filing date: 2018-11-09
Publication date: 2020-05-19
Anticipated expiration: 2038-11-09
Also published as: CN111166507B

Abstract

Aiming at the current situations that the preparation operation of the front tooth porcelain veneered tooth body is difficult, excessive grinding of tooth body tissues is easy to occur and dental pulp sensitivity is caused, the invention provides the personalized tooth body preparation step-by-step indication guide plate which is designed and manufactured in a digital mode, and the personalized tooth body preparation step-by-step indication guide plate is characterized in that: the guide plate is designed and manufactured by a digital method, is used for accurate tooth preparation of the front tooth porcelain veneering, can realize accurate grinding of hard tissues of teeth step by step and achieves the purpose of minimally invasive surgery. The step guide indicates tooth preparation in three steps: firstly, using a cutting adjacent guide plate to indicate the preparation of a cutting end and an adjacent surface; secondly, indicating labial preparation by using a labial guide plate; and thirdly, indicating the preparation of the gingival margin by using a gingival margin guide plate. The guide plate is accurately designed through a digital method, then the preparation of the tooth body is guided step by step, the problem of insufficient or excessive preparation amount is avoided, the operation difficulty of a clinician can be reduced, the quality of clinical restoration and the satisfaction degree of a patient are improved, and the guide plate is a beneficial attempt of an accurate medical concept in the field of oral restoration.

Description

Personalized tooth preparation step-by-step indication guide plate designed and manufactured in digital mode

Technical Field

The invention relates to a personalized front tooth porcelain veneering preparation step-by-step indication guide plate, in particular to a manufacturing method and application of a personalized front tooth porcelain veneering preparation guide plate capable of assisting a stomatologist in accurate porcelain veneering tooth preparation in the aesthetic restoration process of a front tooth veneer.

Background

In recent years, with the improvement of the quality of life of people, the full-ceramic veneering restoration has become popular among more and more patients and oral clinicians, and becomes one of the treatment methods for restoring anterior teeth gaps, dental fluorosis, tetracycline pigmentation teeth, deformed small teeth and the like, due to the high success rate and good long-term restoration effect. However, although the diagnostic finish concept has been proposed in recent years to allow a patient to visually perceive the rough effect of the veneered restoration of the tooth in the mouth and to allow the actual restoration to duplicate the form of the diagnostic finish of the tooth as much as possible, the patient cannot fully recognize the final restored form of the tooth in advance. The final healing effect is often not completely satisfactory to the patient.

The traditional silica gel indicating guide plate can guide the preparation of teeth to a certain extent, but is not real-time and completely objective because the material is not rigid and is easy to deform and can only guide from a single layer. Conventional veneering preparation may result in either an insufficient or excessive amount of preparation. If the preparation amount is insufficient, the strength or the shape of the final restoration is affected; if the preparation amount is excessive, the remaining dental tissue is further damaged, and the dental pulp is stimulated, which causes tooth sensitivity.

Accurate tooth preparation is closely related to the effect of the final veneered restoration and the satisfaction of the patient. The method comprises the steps of designing a restoration form in a three-dimensional mode through a digital method, communicating with a patient before an operation, designing and manufacturing a step-by-step indication guide plate for tooth preparation according to the final restoration form by using the digital method, and finally manufacturing the restoration according to the original restoration form. The prosthesis design and manufacture and the tooth preparation mode can reduce the clinical operation difficulty of doctors, improve the tooth preparation precision, achieve the aim of minimally invasive treatment, improve the veneering repair quality and the satisfaction degree of patients and reduce medical disputes. On the basis, the design and the manufacture of the prosthesis can be completed when the guide plate is manufactured, and the prosthesis is directly worn on a patient after the tooth body is prepared, so that the accuracy and the high efficiency are really achieved.

Disclosure of Invention

Aiming at the defects in the prior art, the invention aims to provide the personalized front tooth porcelain facing preparation step-by-step indication guide plate which is beneficial for clinicians to carry out digital design and manufacture of the front tooth porcelain facing tooth preparation. The method aims to solve the problems that a guide plate in veneering preparation is not objective and accurate enough and veneering repair is not visual enough in the prior art. In order to solve the technical problem, the application adopts the following technical scheme: a personalized tooth body preparation step-by-step indication guide plate designed and manufactured in a digital mode is characterized in that: an ideal anterior tooth form is reconstructed through three-dimensional modeling, and a step-by-step indication guide plate for tooth preparation is designed and manufactured by a digital method. The guide is divided into three parts, the first part (the cutting adjacent guide) is used for the cutting end and adjacent surface preparation step, the second part (the lip side guide) is used for the lip side preparation step (the part is divided into two small parts for carrying out), and the third part (the gingival margin guide) is used for the gingival margin preparation step.

The specific process comprises the following steps:

(1) according to the conditions of the upper dentition and the lower dentition in the mouth, 3-Shape scanning is adopted, the anterior tooth form is stored, meanwhile, data which are multiple sources are exported, the ideal anterior tooth form is designed, and the communication with a patient is realized to reach the consistency;

(2) the thickness and shape of the guide plate are designed by computer aided design software Geomagic 2012. The method is characterized in that: the thickness is 300 μm, and the part contacted with the tooth body extends to 1 adjacent tooth in the near and far;

(3) importing the designed three-dimensional structure model data into digital cutting control software in an STL format;

(4) the cutting material used by the guide plate is polymer Polyetheretherketone (PEEK);

(5) respectively soaking the molded product in 75% ethanol solution for 24h, soaking in deionized water for 30min, and performing Co60 gamma ray irradiation sterilization;

(6) when the veneering preparation is clinically carried out, firstly, an adjacent cutting guide plate is fixed on a tooth to be prepared and adjacent teeth, and then a cutting end and adjacent surfaces of the tooth body tissues exposed outside the guide plate are ground by using a machine needle; then the labial guide plate is replaced, exposed labial tooth body tissues are abraded by using a lathe needle, and finally the gingival margin guide plate is fixed to prepare the gingival margin according to the guide.

Compared with the existing silica gel indicating guide plate, the tooth preparation step-by-step indicating guide plate manufactured by the invention has the following advantages:

the invention designs the restoration form in three dimensions by a digital method, well communicates with a patient before operation, then designs and manufactures a step-by-step indication guide plate for tooth preparation by using the digital method according to the final restoration form, and finally manufactures the restoration according to the original restoration form. The prosthesis design and manufacture and the tooth preparation mode can reduce the clinical operation difficulty of doctors, improve the tooth preparation precision, achieve the aim of minimally invasive treatment, improve the veneering repair quality and the satisfaction degree of patients and reduce medical disputes. On the basis, the design and the manufacture of the prosthesis can be completed when the guide plate is manufactured, and the prosthesis is directly worn on a patient after the tooth body is prepared, so that the accuracy and the high efficiency are really achieved.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a digital design and manufacture personalized tooth preparation step-by-step indication guide plate

Detailed Description

The invention is further illustrated with reference to the following figures and examples.

A digitally designed and manufactured personalized tooth preparation step-by-step indication guide plate is characterized in that: the ideal anterior tooth form is reconstructed by three-dimensional modeling, the guide is divided into three parts, a cutting adjacent guide-a step for cutting end and adjacent surface preparation, a labial guide-a step for labial preparation (divided into two small parts again), and a gingival margin guide-a step for gingival margin preparation.

Taking the abutting type adjacent surface expanding type veneering restoration of four maxillary anterior teeth including a right upper incisor, a right upper middle incisor, a left upper middle incisor and a left upper incisor as an example, the implementation of the personalized tooth preparation step-by-step indication guide plate which is digitally designed and manufactured comprises the following steps:

(1) firstly, aiming at the aesthetic defect conditions of four maxillary anterior teeth of a patient, namely the upper right incisor, the upper right middle incisor, the upper left incisor and the upper left incisor, taking a research model, adopting 3-Shape scanning according to the conditions of the upper and lower dentitions in the mouth, storing the anterior tooth form, simultaneously exporting data which is multi-source, designing an ideal anterior tooth form, and communicating with the patient to achieve the consistency;

(5) soaking in 75% ethanol solution for 24 hr, soaking in deionized water for 30min, and sterilizing by Co60 gamma ray irradiation;

(6) when the veneering preparation is clinically carried out, firstly, an adjacent cutting guide plate is fixed on a tooth to be prepared and adjacent teeth, and then, a preparation lathe needle is used for grinding tooth body tissues exposed at the cutting end and with the adjacent surfaces outside the guide plate; then replace with labial guide, use car needle to abrade exposed labial tooth body tissue, finally fix gingival margin guide), prepare gingival margin according to the guide.

It should be understood that the detailed description of the present invention is only for illustrating the present invention and is not limited by the technical solutions described in the embodiments of the present invention, and those skilled in the art should understand that the present invention can be partially modified or substituted with equivalents to achieve the same technical effects; as long as the use requirements are met, the method is within the protection scope of the invention.

Claims

1. A personalized tooth body preparation step-by-step indication guide plate designed and manufactured in a digital mode is characterized in that: the guide plate comprises three parts, wherein the first part is a cutting adjacent guide plate and is used for the preparation steps of cutting ends and adjacent surfaces, the second part is a labial guide plate (which is divided into two parts of a cutting end 1/2 guide plate and a gingival end 1/2 guide plate) and is used for the labial preparation step, and the third part is a gingival edge guide plate and is used for the gingival edge preparation step.

2. A digitally designed personalized dental preparation step-and-index guide as claimed in claim 1, wherein: the ideal aesthetic form of the anterior teeth is reconstructed through three-dimensional modeling, a corresponding guide plate structure is cut according to standard preparation amount, the cutting adjacent guide plate is a guide plate which is contacted with the anterior labial lingual side and is used for cutting end and adjacent surface preparation, the labial side guide plate is a guide plate which is contacted with adjacent teeth, labial sides or gingival end soft tissues and is used for preparing the anterior labial side, the gingival edge guide plate is a guide plate which is contacted with gingival end soft tissues and a lathe needle and is used for preparing shoulder, when the preparation of the anterior porcelain veneering and veneering tooth body is clinically carried out, the cutting adjacent guide plate is fixed firstly, the tooth body tissues with the cutting end and the adjacent surface exposed outside the guide plate are ground by using the prepared lathe needle, then the labial side guide plate is replaced, the labial side tooth body tissues exposed outside the guide plate are ground by using the lathe needle, and finally the gingival edge guide plate is fixed and the gingival step.

3. A digitally designed personalized dental preparation step-and-index guide as claimed in claim 2, wherein: the tooth is manufactured according to an ideal anterior tooth form according to standard prepared amount in three parts, the thickness is 300 mu m, the part of the first part contacting with the tooth body is expanded to 1 adjacent tooth in the near and far, and the second part and the third part are limited to the prepared tooth.

4. A digitally designed personalized dental preparation step-and-index guide as claimed in claim 2, wherein: the cutting material used for the guide plate part is polymer Polyetheretherketone (PEEK).

5. The digitally designed personalized dental preparation step-and-index guide of claim 4, wherein: the PEEK is a semi-crystalline polymer material, the melting point is 334 ℃, the softening point is 168 ℃, and the tensile strength is 132-148 MPa.

6. A digitally designed personalized dental preparation step-and-index guide as claimed in claim 2, wherein: after forming, the mixture is respectively soaked in absolute ethyl alcohol and 0.5 percent NaOH solution for 24 hours, soaked in deionized water for 30 minutes, and sterilized by Co60 gamma ray irradiation.