巴西专利BR112013029187B1 method and system for establishing the shape of the cavity for access to occlusion in endodontic tre

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专利摘要:
METHOD AND SYSTEM FOR ESTABLISHING THE FORMAT OF THE CAVITY OF ACCESS TO THE OCCLUSION IN ENDODONTIC TREATMENT. The present invention relates to a computer-based method and system for defining and representing a shape and geometry of an occlusal access cavity for tooth roots prior to endodontic treatment, comprising the step or means for: loading into the computer the geometry information of a tooth obtained through one or more imaging techniques, the creation of a 3D computer model of the tooth, including its internal architecture, visualization of the computer model, visualization of the input locations for the tooth channels. root with respect to the occlusal surface of the tooth, and based on the locations of the root canal holes an access cavity shape is calculated.
公开号:BR112013029187B1
申请号:R112013029187-7
申请日:2011-12-12
公开日:2021-04-20
发明作者:Carl Van Lierde；Veerle Pattijn；Paul-Henri Vallotton
申请人:Dentsply Implants Nv；Maillefer Instruments Holding Sarl；
IPC主号:

专利说明:

[0001] The present invention relates to methods, computer programs and software, tools and systems for establishing the occlusion access cavity format in endodontic treatment. Background
[0002] During endodontic root canal treatment, the pulp and nerves of the tooth are removed from the root canals when they are injured or sick. Treatment can be surgically performed by removing the apex of the tooth root (an apicoectomy) and sealing (filling) the root canal through an access hole made through the patient's jaw bone. However, the most conventional treatment approach is to open the tooth occlusally, create a cavity (including the pulp chamber) providing access to the canal orifices, remove the diseased pulp and nerves, remove the diseased dentin by using specialized instruments such as such as endodontic files to mechanically shape the root canals, clean and disinfect the root canals by means of specific irrigation, and seal and seal them to prevent any bacteria from gaining access to the treated area.
[0003] A well-known problem with this type of approach is related to instrument fracture. According to the literature ("The Impact of Instrument Fracture on Outcome of Endodontic Treatment," Peter Spili, BSc, BDSc, Peter Parashos, MDSc, PhD, and Harold H. Messer, MDSc, PhD, JOE - Volume 31, number 12 , December 2005, pages 845 to 850), the prevalence of fractured endodontic hand instruments has been reported to range from 1 to 6%. It is the second most important reason for medico-legal claims in endodontics and accounts for approximately 5.6% of all dental claims ("Medical-Legal Aspects of Endodontic Treatment", David Kan, Hong Kong Dental Journal 2004; 1 :99-100). In cases with a periapical lesion, fragments retained from the endodontic instruments have been reported to reduce healing. One of the most common causes of instrument fracture is inadequate preparation of the occlusal cavity that provides access to the pulp chamber and connected root canals. Often the cavity size is undersized or improperly formatted. This results in improper instrument bending during pulp removal, ultimately resulting in instrument failure. Additionally, inadequate preparation of the access cavity may result in not reaching a main root canal, for example, the fourth mesiobuccal canal in an upper molar tooth. Since the effectiveness of endodontic treatment is highly dependent on the extent to which diseased/infected tissue is removed, failure to treat a root canal can eventually result in treatment failure. Ideally, the access cavity should provide straight-line access and a glide path that helps the instruments to have maximum capacity. Incomplete access increases the tension on the sandpaper and results in breakage.
[0004] For a practitioner it is, however, very difficult to properly prepare the access cavity due to limited visibility and due to the location of the root canal holes it is basically uncertain (in 3D) before the start of treatment. Typically, the practitioner drills the tooth until a first access is made to the pulp chamber. Subsequently, this access is gradually extended while searching for the root canals. Without reliable information about the root canals, in particular their number and location of their holes in the pulp chamber floor, there is a greater degree of probability that the access cavity will not be properly sized. Furthermore, in some cases much of the healthy occlusal tissue can be removed, potentially compromising an easy prosthetic restoration of the tooth.
[0005] In the prior art it is known to use CT image to obtain a three-dimensional view of the tooth and corresponding root canals. Patent application PCT/EP2011/052457 teaches a method and system for 3D digital endodontics characterized by the fact that 3D imaging equipment such as a CT or MRI scanner, ultrasound or similar are used to scan the tooth or teeth patients, subsequently a 3D representation of the root canal system is extracted from the image data and viewed on a computer screen, and a surgical template is designed to guide the endodontic instruments to locate the root canals intraoperatively. Additionally, the location of the root channel holes is determined by extracting the root channel system from the data and image, for example, by indicating points along the geometric axis of the root channel in one or more slices of the image set. . These points are connected and create a 3D line graph that represents the tooth's root canal system.
[0006] While this method provides information about the root canals and helps through a guide in locating the root canals intraoperatively, it does not mention or teach how to prepare and format the access cavity for the pulp chamber in such a way that straight-line access is made to each of the identified root canals, without removing excess material from the occlusal surface of the tooth. Thus, instrument fracture can still occur.
[0007] According to the current state of the art, there is no way to optimize the shape of the access cavity depending on the prosthetic restoration (eg, inlay, crown) of the tooth subsequent to endodontic treatment.
[0008] Among the remaining prior art, there are some other solutions referring to the use of a computer to improve endodontic treatment. WO2011019846 discusses a dental handpiece with an integrated camera and computer that allows for pre-programmed procedure steps and feedback as treatment proceeds. The computer transmits camera images and data retrieved from the built-in sensors to the professional via an attached monitor. The method and system described, however, do not discuss the formatting or preparation of the access cavity for the pulp chamber, for example, in order to prevent instrument fracture or to optimize the prosthetic restoration capabilities after endodontic intervention. Invention Summary
[0009] An objective of the present invention is to provide a method, tools or system to define and represent the shape and geometry of the occlusal access cavity for tooth roots before endodontic treatment. Another objective of the present invention is to provide a method, tools or system for transferring information around the desired shape of the occlusal access cavity to the patient's tooth during endodontic treatment.
[00010] The present invention seeks to reduce or overcome at least one of the problems of prior art methods and devices.
[00011] According to the present invention, the definition of the shape and geometry of the occlusal access cavity for the tooth can be performed using a computer or a computer system such as a computer network. The geometry information (internal and external) of the tooth to be treated can be acquired through one or more imaging techniques. The nature of the images (2D, 3D, surface information, volumetric information, etc.) used to capture geometric information about the tooth may vary as does the nature of the imaging technique used (X-ray, CT, MRI, ultrasound, etc.). ). Potentially, multiple image modalities can be combined.
[00012] The acquired information is used to create a 3D computer model of the tooth, including its internal architecture, that is, root canals and pulp chamber. The computer model can be viewed in any form of the display device such as a computer screen, a projected monitor, a head-mounted monitor, in sectional views or in a 3D representation such as a surface model or a volume. .
[00013] The locations of the entries for the root canals (with respect to the occlusal surface of the tooth) as well as information about the 3D curvature of the root canals are taken from the computer model of the tooth. The level of automation for this step can vary. In one embodiment, the method and system are adapted, for example, by providing a suitable recording medium, such as a keyboard, mouse, etc. and software to allow the user to log data. For example, points along root channels can be indicated by any suitable means, eg via the graphical user interface or by recording their 3D coordinates numerically. According to another embodiment, feature recognition algorithms or the like are used by the method or system to discriminate the root channels with respect to the remainder of the tooth. Other modalities may require the system to utilize a combination of user registration and/or image processing tools and/or root-of-tooth geometry statistical data.
[00014] It is a feature of the present invention that based on the determined locations of the root canal holes a shape of the access cavity is calculated. The calculation may or may not take into account information on the 3D tooth curvature and/or requirements regarding the desired prosthetic restoration of the tooth subsequent to endodontic treatment and/or requirement/limitation regarding the use of endodontic instruments.
[00015] It is another feature of the present invention that based on the calculated shape of the access cavity, a general line is calculated from the occlusal surface of the tooth indicating the surface boundaries of the access cavity on the occlusal side of the tooth. Means are provided for viewing this outline on the display device such as the computer screen, for example, in an occlusal view of the tooth and transferred to the patient's mouth, for example, by means of a custom mold.
[00016] A significant advantage of the present invention is that dentists are substantially assisted in the planning of root canal treatment having unambiguous guidelines implemented in the sense of how to optimally format the access cavity based on patient-specific information . The invention also constitutes a considerable saving in chair time since the dentist can start the treatment knowing how many root canals to clean, where to look and how to size the access cavity. There is no need for exploration during the treatment itself, nor are there any remaining uncertainties as to whether or not all necessary root canals have been treated.
[00017] Another advantage of the present invention is that the access cavity can be readily prepared to ensure straight-line access to the root canals and minimal bending of the endodontic instruments to prevent their breakage.
[00018] These and other objectives, features and advantages of the invention will become apparent from the following detailed description, where reference is made to the figures in the attached drawings. Brief Description of Drawings
[00019] The drawings described are only schematic and are not limiting. In drawings, the size of some elements may be exaggerated and not drawn to scale for illustration purposes.
[00020] Figure 1 illustrates a 3D computer model of a tooth that is the internal architecture, that is, pulp chamber and root canals that can be used with the present invention.
[00021] Figure 2 illustrates a cross section of a tooth and a 2.5D representation of the same tooth through contours that can be used with the present invention.
[00022] Figure 3 illustrates a system for establishing the shape of the occlusal access cavity in endodontic treatment using feature recognition algorithms to identify the root canals and their respective entries according to an embodiment of the present invention.
[00023] Figure 4 illustrates a graphical user interface to indicate points along the root channel through which a 3D curve is fitted according to an embodiment of the present invention.
[00024] Figure 5 illustrates a transverse and occlusal view of a tooth for which the calculated (recommended) access cavity was determined according to an embodiment of the present invention.
[00025] Figure 6 illustrates straight lines fitted through the respective 3D curves associated with the root canals of a tooth, forming an intersection with the occlusal surface of said tooth, thus defining the general line of the access cavity in that surface of according to an embodiment of the present invention.
[00026] Figure 7 illustrates straight lines fitted through the respective 3D curves associated with the root canals of a tooth, forming an intersection with the surface of the pulp chamber according to an embodiment of the present invention. The connected intersection points thus define the general line of the access cavity on the surface of the pulp chamber, the projection of which on the occlusal surface of the tooth defines the shape of the access cavity.
[00027] Figure 8 illustrates a prepared piece of tooth and the desired prosthetic reconstruction in the form of a tooth crown.
[00028] Figure 9 illustrates a cross section of a crown and piece of tooth, the latter being prepared with an undercut with respect to the direction of insertion of the crown according to an embodiment of the present invention.
[00029] Figure 10 illustrates a tooth to be prepared for receiving the crown (artificial), with the root channels substantially skewed with respect to the original crown according to an embodiment of the present invention.
[00030] Figure 11 illustrates a 3D computer model of the tooth with the general line of the suggested access cavity illustrated on its occlusal surface and different means (ie, mold, transparent, glasses and navigation system) for transferring said general line of the tooth in the patient's mouth in accordance with an embodiment of the present invention.
[00031] Figure 12 illustrates a schematic computer system that can be used with the present invention. Description of Preferred Modalities
[00032] The present invention will be described with respect to particular embodiments and with reference to certain drawings, but the invention is not limited thereto, but only by the claims.
[00033] According to a preferred embodiment of the invention, a three-dimensional computer model 16 of the tooth 1 including the pulp chamber 2 and the root canals 3, is needed and obtained. Tooth enamel, bone and soft tissue are visible. The method starts when said three-dimensional computer model 16 is available. In a first subsequent step, the locations of the root canal holes 4 (with respect to the occlusal surface of the tooth) are extracted from the computer model 16 of tooth 1. According to one approach, this step is fully automated. As an example, automation consists of the following sequence of actions performed by system 17. First, the apical-coronal (longitudinal) axis 5 of tooth 1 is determined. This can be done, for example, based on the calculation of the main geometric axes of inertia of tooth 1. Once the main geometric axis has been calculated, the plane intersection curves (ie contours) 6 are calculated with the representation of teeth equidistantly along said geometric axis. The result is a set of contours providing a 2.5D 7 representation of tooth 1. This set of contours consists of the outer contours 8 representing the surface of tooth 10 and the inner contours 9 representing the root canals 3 and the pulp chamber 2. The locations of the entry points 4 for the root canals are determined by scanning the plane intersections (slices) 6 along the geometric axis, in the apical direction of tooth 1, starting at a specified distance from the crown surface (this is , occlusal) 11 of the tooth. The transition from pulp chamber 2 to root canals 3 is marked by the fact that the area 21 enclosed by the inner contour 9 of tooth 1 reaches a predetermined threshold value (as is typically the case for incisors) or by the fact that the inner contour 9 divide into multiple contours 12 (as typical in the case of a molar or premolar). The latter can occur at different levels along the geometric axis of the longitudinal tooth 5, for example, in the case of three or more roots. Having determined the slices 14 that mark the transition between the pulp chamber 2 and the root channels 3, the locations of the root channel holes 4 are provided, for example, by the centers of gravity 13 of the internal contours corresponding to these slices.
[00034] According to another example, automation consists in the use of feature recognition algorithms by the system. Features 15 are mathematical representations (eg matrices) of possible shapes of a tooth root canal 3. A feature is recognized, for example, when a given correlation value becomes greater than a given value. Once the feature (ie root canal) has been identified, its entry is also known with respect to occlusion surface 11 of tooth 1.
[00035] Using a different approach, the root canal holes are provided as a record in system 17. This approach requires end-user interaction, which can be facilitated by system 17 through a graphical user interface 18 which allows the user to indicate the relevant points 4 on the 3D computer model 16 directly. Alternatively, the record can be provided numerically by recording in system 17 the coordinates of the input points, for example via a keyboard 19.
[00036] In an optional second step, information about the 3D curvature of root canals 3 is extracted from the computer model 16 of tooth 1. So far the midline 20 of each root canal 3 can be determined in a shape (semi ) automatic by the system 17. As in the previous step, the calculation of these intermediate 3D lines 20 can also be automated to varying degrees. According to a simple implementation, a 3D curve 22 is fitted through several points 23 along the root channel 3, where these points 23 have been provided as user registration in system 17. More advanced implementations may use slices 6 as described previously to determine successive gravity center points 14 for contours 6 along root channels 3 and fit into a curve. Other implementations are possible. With a 3D curve 22 associated with each root channel 3, 3D curvatures are created by applying the appropriate mathematical formulas.
[00037] In a third step, the system 17 determines the shape of the access cavity 31 for the pulp chamber 2 based at least on the locations of the inlets 4 to the root channels 3. According to an embodiment, a plan 24 is fitted through the occlusal surface 11 of tooth 1. Next, the entry points 4 to the root canals 3 are projected into that plane 24 according to a direction perpendicular to said plane 24. Around each entry point projected 25 on plane 24, a circle 26 is defined with a predefined diameter, eg 100 Dm. Circles 26 are then connected in plane 24 with straight lines 27 such that all circles are encompassed by the resulting boundary 28, minimizing the enclosed surface area 29. In the case of only one root channel 3 the boundary 28 will consist of one single circle. Boundary 28 is then extruded along the apical-coronal (longitudinal) axis 5 of tooth 1 and the intersection 29 of the resulting 3D volume 30 with the 3D model 16 of tooth 1 is calculated. The shape of the intersecting part 29 between the occlusal surface 11 and the pulp chamber 22 defines the shape of the access cavity (in this case parallel wall) 31.
[00038] According to another embodiment, the system 17 uses the additional information around the 3D curvatures of the roots to calculate the shape of the access cavity 31. In this case a straight line 33 per root channel 3 is defined crossing the point of entry 4 of the root channel 3 and fitted through a predetermined portion 32 of the 3D curve 22 associated with said root channel 3. At its limit, the line 33 is fitted through the entire 3D curve 22. The resulting lines 33 to each root canal 3 are extended to occlusal surface 11 of tooth 1. Points 34 arising from lines 33 from occlusal surface 11 are then connected with curves 35 on said surface 11 according to a shorter length principle . This provides an overall line 36 on the occlusal surface 11 of the edges 28 of the access cavity 31. Optionally, an external offset 37 can be applied to said edges 28 to enlarge the access cavity 31, depending on the size of the endodontic instruments to be used. In cases where only one or two root canals 3 are present, the access cavity 31 can be a single hole (with a given diameter), two separate holes or a partition (ie a line cavity with a given width) . The walls 38 of the access cavity 31 are provided by respective surfaces generated by connecting the line segments between corresponding points on straight lines 33 extending from the root channels 3. Alternatively, the lines 33 fit through the portion 32 of the curve 3D 22 associated with respective root channels 3 are extended to surface 39 of pulp chamber 2 and points of intersection 40 with said surface 39 are calculated. Said points 40 are connected with curves on the surface 39 according to the shortest path. The thus highlighted boundary 41 is projected onto the occlusal surface 11, thus defining the shape of the access cavity 31. The walls 38 of the access cavity 31 are defined as a sweep of a line parallel to the direction of projection along the boundary 41. The direction of projection can, for example, be the middle direction of the extended lines 33 associated with the respective root canals 3, or perpendicular to a plane 24 fitted across the occlusal surface 11 of tooth 1 or even randomly specified by the user end of system 17. Optionally, boundary 41 highlighted on surface 39 of pulp chamber 2 can be provided for an external offset prior to projection to occlusal surface 11.
[00039] According to another embodiment of the present invention, the system 17 uses additional information about the desired prosthetic reconstruction 42 to determine the shape and size of the access cavity 31. As an example, the prosthetic restoration 42 of tooth 1 subsequent to endodontic treatment can be a dental crown 43. Certain requirements exist for preparing the piece of tooth 44 on which the crown 43 will be cemented. These requirements may not always be compatible with the general guidelines recommended for preparing access cavity 31 for root channels 3 based on information from root channels 3 only. A compromise may be necessary to ensure the best possible access to tooth 3 canals and to allow crown 43 to be properly attached to tooth piece 44 subsequent to endodontic treatment.
[00040] According to a desired insertion direction 45 of the crown 43 on the tooth piece 44, the latter must be prepared in such a way that there are no indentations 46 when cementing the crown 43 on top of the tooth piece 44. Additionally, the marginal preparation edge 47 of the tooth piece 44 must have a determined profile allowing the smooth transition (ie, the emergence profile) from the crown 43 to the root 48. Additionally, the piece 44 must be grounded homogeneously (often more or less conically). This grinding process, however, must be controlled due to the minimum thickness requirements (D) between surface 49 and tooth piece 44 and pulp chamber 2. When tooth 1 root channels 3 to be prepared for the receipt of the (artificial) crown 43 are oriented substantially skewed with respect to the original crown 50, the cavity 31 suggested by the system based only on the straight line access principle/minimum fold may preclude further preparation by the dentist of the piece 44 suitably, for example, as much material 51 has been removed to gain access to channels 3. This can be rectified by system 17. According to a first illustrative approach, two lines are drawn at each of the input points 4 of the root canals 3, a line 52 parallel to the predefined insertion direction of the prosthetic element and a line 33 fitted through the 3D curve (or a part thereof) following the respective root canal. Each pair of lines 53 originates a respective entry point 4 of the root channels 3. Next, the system 17 calculates for each root channel 3 the respective bisector 54 of said pair of lines 53. Instead of using the extended lines 33 fitted through the 3D curves 22 following the root channels 3, the bisectors 54 are now used in calculating the shape of the access cavity 31 (as described above).
[00041] According to another embodiment of the present invention, the system 1 allows the general line 36 of the access cavity 31 on the occlusal surface 11 of tooth 1 to be transferred into the patient's mouth. According to one implementation, the system 17 designs a mold 55 that fits the occlusal (and/or lingual and buccal) surface 11 of tooth 1 (and/or neighboring teeth), and incorporates the general line 36 of the access cavity 31 , for example, as a central opening 56 in mold 55. The general line can thus be traced on the tooth using a medical marker. Said mold can be manufactured using a variety of techniques such as grinding, rapid prototyping or the like.
[00042] Alternatively, the system 17 sends through the graphical user interface an occlusal view 57 of tooth 1 with the boundary 36 of cavity 31 indicated on a scale of 1:1. This view can, for example, be converted to a tool by being printed on clear plastic 58 and used during endodontic treatment as a coating on tooth 1 to match the actual cavity preparation. More advanced systems can be contemplated, for example, where the coating is designed on spectacles 59 used during endodontic treatment and corrected as a function of head movements in relation to the position of tooth 1. Navigation systems 60 allowing the visualization of endodontic instruments and the tooth indicating the boundary 36 of the cavity 31 on the computer screen during the preparation of the access cavity 31 can guide the dental specialist in preparing the access cavity 31 as planned.
[00043] Figure 12 is a schematic representation of a computing system that can be used with the methods and in a system according to the present invention including computer programs such as 3-matic as supplied by Materialise NV, Leuven, Belgium . A computer 150 is shown and may include a video monitor terminal 159, a data recording device such as a keyboard 155, and a graphical user interface indicating means such as a mouse 156. The computer 150 may be implemented as a general-purpose computer, for example, a UNIX workstation or a personal computer.
[00044] Computer 150 includes a Central Processing Unit ("CPU") 151, such as a conventional microprocessor of which a Pentium processor supplied by Intel Corp. U.S.A. is just one example, and a number of other units interconnected through the bus system 154. The bus system 154 can be any suitable bus system, the figure above being just schematic. Computer 150 includes at least one memory. The memory may include any of a variety of data storage devices known to those skilled in the art such as random access memory ("RAM"), read-only memory ("ROM") and non-volatile read-write memory such as like hard disk as known to those skilled in the art. For example, computer 150 may additionally include random access memory ("RAM") 152, read-only memory ("ROM") 153, in addition to a display adapter 1512 for connecting system bus 154 to a display terminal. 159, and an optional input/output (I/O) adapter 1511 for connecting peripheral devices (eg, floppy disk and tape drives 158) to system bus 154. Video monitor terminal 159 may be the computer's visual output 150, which may be any suitable display device such as the CRT-based video monitor well known in the computer hardware art. However, with a desktop computer, laptop or notebook computer, a 159 video monitor terminal can be replaced with a flat panel LCD or gas plasma monitor. Other forms of monitor can be glasses worn during endodontic treatment. Computer 150 additionally includes user interface adapter 1510 for connecting a keyboard 155, mouse 156 and optional speaker 157. Relevant data describing the 3D model can be entered directly into the computer using keyboard 155 or from computer devices. storage such as 158, after which a processor performs a method according to the present invention. Any of the results of the method can be transmitted to an additional nearby or remote location, for example, a CAD/CAM processing or printing facility for fabrication of crowns, molds, tools such as printed plastic templates (as described above) in accordance with the details provided by the computer 150.
[00045] A printing system or a CAD/CAM 1516 manufacturing unit can also be connected via a communications adapter 1517 to bus 154 connecting the computer 150 to a data network such as the Internet, an Intranet or a Local Area network or Wide (LAN or WAN) or a CAN. The fabrication unit 1516 can receive a descriptor file suitable for fabrication of crowns, molds, tools such as printed plastic templates (as described above), directly from the computer 150 running in a computer program for establishing the shape of the occlusal access cavity in endodontic treatment according to the present invention or a descriptor value or file derived from such computer output 150. Alternatively, unit 1516 may receive the relevant design data indirectly in a suitable signal storage medium such as a floppy disk, a replaceable hard disk, an optical storage device such as a CD-ROM or DVD-ROM, a magnetic tape, or the like.
[00046] Computer 150 also includes a graphical user interface that resides within the machine-readable medium to direct the operation of computer 150. Any suitable machine-readable medium may retain the graphical user interface, such as random access memory (RAM) 152, a read-only memory (ROM) 153, a magnetic floppy disk, a magnetic tape, or optical disk (the last three being located on disk and tape drives 158). Any suitable operating system and associated graphical user interface (eg, Microsoft Windows, Linux) can drive CPU 151. Additionally, computer 150 includes a driver program 1517 that resides within computer memory store 1561. control 1571 contains instructions that when executed on the CPU 151 allow the computer 150 to perform the operations described with respect to any of the methods of the present invention.
[00047] The computer 150 can be used in a computer-based method for 3D endodontics, 3D imaging equipment being used to digitize an image of an infected tooth or teeth to thereby form image data. 3D imaging equipment serves for generating volumetric data such as a CT scanner, an MRI scanner or an ultrasound scanner.
[00048] The user interface is preferably adapted to extract the shape of the occlusal access cavity from the image data displayed on a visual display unit. The user interface is preferably adapted to allow 3D and transverse views of the root canal in the coronal, sagittal and/or transverse planes.
[00049] Software running on the computer system is preferably provided for determining the location of the root canal holes, by extracting the root canal system from the image data. This extraction step can be performed by indicating points along the geometric axis of the root channel in one or multiple slices of the image. Points can be connected and can create a 3D line graph representative of the tooth root canal system.
[00050] The user interface and software running on the computer system are preferably adapted for viewing the orifice of each root canal as a dot with a distinct color. Optionally, the root canal hole can be expressed as coordinates in a tooth-specific coordinate system.
[00051] Those skilled in the art will appreciate that the hardware depicted in Fig. 12 may vary for specific applications. For example, other peripheral devices, such as optical disk media, audio adapters, or chip programming devices, such as PAL or EPROM programming devices well known in the computer hardware art, and the like can be used in addition to or in place of the hardware already described.
[00052] In the example shown in Figure 12, the computer program product for carrying out the method of the present invention may reside in any suitable memory. However, it is important that those skilled in the art appreciate that the mechanisms of the present invention can be delivered as a computer program product in a variety of ways, and that the present invention is equally applicable regardless of the particular type of support medium. used to actually perform the distribution. Examples of computer readable signal media include: recordable type media such as floppy disks and CD ROMs, solid state memories, tape storage devices, magnetic disks.
[00053] Accordingly, the present invention also includes a software product that when run on a suitable computing device performs any of the methods of the present invention. Suitable software can be obtained by programming in a suitable high-level language such as C and compiling into a suitable compiler for the target computer processor.

权利要求:
Claims (25)
[0001]
1. Computer-based method for defining and representing a shape and geometry of an occlusal access cavity (31) of tooth roots (1) before endodontic treatment, the method comprising: loading geometry information into the computer of a tooth (1) obtained through one or more imaging techniques; create a 3D computer model (16) of the tooth (1), including its internal architecture, visualize the computer model; view the entry locations for the root canals (3) with respect to the occlusal surface (11) of the tooth (1); characterized by the fact that based on the locations of the holes (4) of root canal (3) an access cavity shape is calculated by using a calculating device, based on the calculated shape of the access cavity, a general line (36) is calculated on the occlusal surface (11) of the tooth (1) indicating the surface boundaries of the access cavity on the occlusal side of the tooth (1), and the method further comprising: viewing this general line (36) in the display device such as a computer screen.
[0002]
2. Method according to claim 1, characterized in that the information about the locations of the holes (4) of the root channel (3) is combined with the information about the geometric axis of tooth (1) as a whole or the geometric axes of individual roots such that the use of the latest information to determine a direction is defined according to which locations are projected onto the surface of the pulp chamber (2) or the occlusal surface (11) of the tooth (1), the shape of the access cavity being dictated by the shortest path curve connecting the projected points, for example, the envelope around the points, the access cavity walls being calculated based on the information of geometric axes of root, the direction of projection, the envelope around the points, or a combination of any of them.
[0003]
3. Method according to claim 2, characterized in that the upper and lower limits are defined by the occlusion surface and the surface of the pulp chamber (2).
[0004]
4. Method according to any preceding claim, characterized in that the shape of the access cavity is based on information about the 3D curvature (22) of the root channels (3).
[0005]
5. Method according to any of the preceding claims, characterized in that it additionally comprises the transfer of information about the shape of the occlusal access cavity (31) to the patient's tooth (1) during endodontic treatment.
[0006]
6. Method according to any one of the preceding claims, characterized in that the image creation technique provides 2D information, 3D information, surface information, or volumetric information.
[0007]
7. Method according to any of the preceding claims, characterized in that the imaging technique is X-ray, CT, MRI, ultrasound, or combinations thereof.
[0008]
8. Method according to any one of the preceding claims, characterized in that the computer model is viewed on a display device such as a computer screen, a projected monitor, a head-mounted monitor, in sectional views or in a 3D representation such as a surface model or a volume.
[0009]
9. Method according to any one of claims 2 to 8, characterized in that the locations of the entrances to the root canals (3) with respect to the occlusal surface (11) of the tooth (1) in addition to information about the 3D curvature (22) of the root canals (3) are extracted from the computer model of the tooth (1).
[0010]
10. Method according to claim 9, characterized in that the accessory recognition algorithms are used to discriminate the root channels (3) with respect to the remainder of the tooth (1).
[0011]
11. Method according to any of the preceding claims, characterized in that based on the determined locations of the holes (4) of the root channel (3) an access cavity shape is calculated, where the calculation takes into account at least one of the group consisting of: i) the information of the 3D curvature (22) of the tooth (1) ii) requirements regarding the desired prosthetic restoration of the tooth (1) subsequent to endodontic treatment iii) requirements/limitations regarding the use of endodontic instruments.
[0012]
12. Method according to claim 1, characterized in that information about the shape of the occlusal access cavity (31) for the patient's tooth (1) during endodontic treatment is obtained by viewing the general line (36) on the display device.
[0013]
13. Method according to claim 1, characterized in that the display device is a computer screen.
[0014]
14. Computer-based system for defining and representing a shape and geometry of an occlusal access cavity (31) for tooth roots (1) before endodontic treatment, the system characterized by the fact that it comprises: data for loading into a computer information of the geometry of a tooth (1) obtained through one or more imaging techniques; means for creating a 3D computer model (16) of the tooth (1), including its internal architecture; a display device adapted for viewing the computer model, the system being adapted for viewing the locations of the entrances to the root canals (3) with respect to the occlusal surface (11) of the tooth (1); and calculating means for calculating an access cavity shape based on the locations of the holes (4) of the root channel (3).
[0015]
15. System according to claim 14, characterized in that the system is adapted to combine information around the locations of the holes (4) of the root channel (3) with information about the geometric axis of the tooth (1) as a whole or of the geometric axes of the individual roots such that the use of the last information determines that a direction is defined according to which the locations are projected on the surface of the pulp chamber (2) or occlusal surface (11) of the tooth (1), the shape of the access cavity being dictated by the shortest path curve connecting the projected points, for example, the envelope around the points, the access cavity walls calculated based on information from root geometric axes , projection direction, envelope around points, or a combination of any of them.
[0016]
16. System according to claim 15, characterized in that the upper and lower limits are defined by the occlusal surface (11) and the surface of the pulp chamber (2).
[0017]
17. System according to claim 14 or 15, characterized in that the system is adapted so that based on the calculated shape of the access cavity, a general line (36) is calculated on the occlusal surface ( 11) of the tooth (1) indicating the boundaries of the surface of the access cavity on the occlusal side of the tooth (1), and the display being adapted to visualize this general line (36).
[0018]
18. System according to any one of claims 14 to 17, characterized in that the shape of the access cavity is based on information about the 3D curvature (22) of the root channels (3).
[0019]
19. System according to any one of claims 14 to 18, characterized in that it additionally comprises means for transferring information about the shape of the occlusal access cavity (31) to the patient's tooth (1) during treatment endodontic.
[0020]
20. System according to any one of the preceding claims, characterized in that the images of the image creation technique comprise 2D information, 3D information, surface information, or volumetric information.
[0021]
21. System according to any one of claims 14 to 20, characterized in that the images of the image creation technique are any one of X-ray, CT, MRI and ultrasound images.
[0022]
22. System according to any one of claims 14 to 21, characterized in that a monitor is a computer screen, a projected monitor, a head-mounted monitor, the monitor being adapted to display in cross-sectional views or in a 3D representation such as a surface model or a volume.
[0023]
23. System according to any one of claims 15 to 22, characterized in that it additionally comprises means for extracting a computer model of the tooth (1), the entry locations for the root channels (3) with relation to the occlusal surface (11) of the tooth (1) in addition to information about the 3D curvature (22) of the root canals (3).
[0024]
24. System according to claim 23, characterized in that the system is adapted to perform accessory recognition algorithms to discriminate the root channels (3) with respect to the remainder of the tooth (1).
[0025]
25. System according to any one of claims 14 to 24, characterized in that it additionally comprises means to calculate, based on the determined locations of the holes (4) of the root channel (3), a shape of the access cavity , where the calculation takes into account at least one of the group consisting of: i) the information on the 3D curvature (22) of the tooth (1) ii) requirements regarding the desired prosthetic restoration of the tooth (1) after endodontic treatment iii) requirements and limitations regarding the use of endodontic instruments.

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同族专利:

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CA2835756A1|2012-11-22|

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BR112013029187A2|2017-01-31|

CA2835756C|2020-01-14|

GB201108002D0|2011-06-29|

US20140322664A1|2014-10-30|

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WO2012155998A1|2012-11-22|

KR20140051854A|2014-05-02|

JP2014516174A|2014-07-07|

EP2707856B1|2018-07-04|

US9138299B2|2015-09-22|

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法律状态:
2018-01-09| B25D| Requested change of name of applicant approved|Owner name: MAILLEFER INSTRUMENTS HOLDING SARL (CH) , DENTSPLY |

2018-01-30| B25G| Requested change of headquarter approved|Owner name: MAILLEFER INSTRUMENTS HOLDING SARL (CH) , DENTSPLY |

2018-12-18| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

2019-10-01| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

2021-03-16| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

2021-04-20| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 12/12/2011, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

申请号 | 申请日 | 专利标题

GB1108002.5|2011-05-13|

GBGB1108002.5A|GB201108002D0|2011-05-13|2011-05-13|Method and system for establishing the shape of the occlusal access cavity in endodontic treatment|

PCT/EP2011/072475|WO2012155998A1|2011-05-13|2011-12-12|Method and system for establishing the shape of the occlusal access cavity in endodontic treatment|

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