METHOD FOR VIRTUALLY DESIGNING A CUSTOMIZED HEALING ABUTMENT AND A GUIDING PUNCTURE FOR A PATIENT AN

专利摘要:
method for virtually designing a customized healing abutment and a guide hole for a patient and kit comprising a customized healing abutment and a guide hole for a patient. The present invention relates to a method for virtually designing a healing abutment customized and a guide perforation for a patient, where the method comprises: - obtaining a CT scan that comprises at least part of the patient's mandibular bone; - virtually position at least one implant in relation to the computed tomography mandibular bone, in such a way that a planned implant placement is defined; - virtually design: - a guide hole to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and - a custom healing abutment configured to conform the soft tissue to a target profile when disposed on the implant; where the design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
公开号:BR112014015343B1
申请号:R112014015343-4
申请日:2012-12-19
公开日:2021-06-22
发明作者:Rune Fisker；Anders Kj/Ir-Niilsin
申请人:3Shape A/S；
IPC主号:

专利说明:

FIELD OF THE INVENTION
[001] This invention relates generally to a system and method for virtually designing a customized healing abutment for a patient. In particular, the invention relates to a system, a user interface and a method for virtually designing a customized guide perforation and healing abutment for a patient. BACKGROUND OF THE INVENTION
[002] Dental prosthesis procedures to replace one or more teeth with dental restorations, such as crowns and bridges, are performed daily by dentists around the world. In cases where a patient's original tooth is either missing or diseased or damaged to a point where it can no longer serve as a support for a dental restoration, the dentist may decide to place an implant in the patient's mandibular bone, such that the dental restoration can be supported by the implant, for example through an implant abutment. When placed in the patient's mouth, implants can replace parts of the tooth that are not visible in a 3D surface scan, such as the tooth roots. If the original tooth or any residue of it is still present in the patient's mouth these will be extracted and a hole for the implant is drilled into the mandibular bone. The implant is placed in this hole and the surrounding bone grows in very close juxtaposition to the implant such that the implant is secured to the bone. This process is also known as osseointegration. In particular, titanium has been shown to have very good osseointegration properties and is currently the most preferred material for use in implants. When osseointegration is complete and the implant is stuck in the bone, it can subsequently be used as a support for dental restorations. Typically, implant abutments are placed on the implant to serve as an interface between the implant and the final restoration which may comprise an anatomical part of the dental restoration such as a crown or bridge and crown layers.
[003] Osseointegration usually takes several months to complete and during this period of time a healing abutment can be placed on the implant in order, for example, to ensure that the implant is kept free of dirt and food. The healing abutment can also be used to shape the soft tissue in the region where the original tooth was extracted in such a way that the soft tissue maintains an anatomically correct shape rather than collapsing into the space that was previously occupied by the extracted tooth.
[004] Once the osseointegration is completed, the healing abutment is removed and the final restoration is disposed on the implant, for example, securing an implant abutment to the implant using an implant screw and cementing the final restoration to the implant abutment.
[005] Document No. WO2011157762 discloses a computer-based method that is used to design a healing cap of an implant. The method is based on a 3D computer plan of the implant that comprises digital representations of the positions of the implants in the patient's mouth. The method comprises loading the 3D implant plan into a computer and combining the 3D implant plan with information about a prosthetic configuration. The method determines a marginal edge of an implant healing cap based on a 3D representation of the existing patient anatomy, the 3D implant plane, and the prosthetic configuration. The healing cap is then manufactured to the custom design.
[006] Document No. US20120115105 discloses a gingiva former, which has a geometry that connects to an implant and comprises a custom-made edge, a tapered bottom that is located below and has a custom-made shape and an upper taper portion having a side surface, wherein the side surface has an inclination angle of between 0.5° and 30° with respect to a longitudinal axis of the connecting geometry.
[007] Document No. US 2009/0111071 discloses a method for designing a digital abutment for a dental implant that includes the steps of: a) planning the implant in which the implant planning is started based on the digital data obtained from from the patient and loaded into a computer system to enable the implant to be implanted into the implant site in the best position, b) establish the digital reference abutment where a digital reference abutment is established at the implant site and positioned on the implant , c) adjust the digital reference post where the digital reference post has a subgingival part and a supragingival part on the top side of the subgingival part and the angle between the subgingival part and the supragingival part is adjusted based on the position better prosthesis and d) finalize the digital abutment where the digital reference abutment becomes a digital abutment for positioning after adjustment.
[008] For surgically drilling a hole inside the patient's mandibular bone for the implant, a guide hole may be arranged in the patient's mouth where it guides the dentist to drill the hole in a planned implant placement. The guide perforation can be designed based on a CT scan of the patient's tooth and fabricated using direct digital fabrication techniques. Document No. US2012/0143364 discloses a dental CAD/CAM system that forms a custom dental preparation guide for guiding a dental tool that changes a shape to a tooth structure to which a custom dental prosthetic item is to be attached. The system acquires an optical measurement and an X-ray of at least one tooth structure. The system correlates with optical measurement and acquired X-rays to form a model of at least one tooth structure. The system generates a model of a reduced tooth structure based on the model of the at least one tooth structure. The system also provides at least one dental preparation guide based on the reduced tooth structure model.
[009] However, it remains to reveal a method, a user interface and a system for designing a guide hole and a customized healing abutment for a patient in which the virtual design of the guide hole and the customized healing abutment at least partially based on computed tomography and planned implant placement. Such a method, user interface and system can ensure that both the guide perforation and the customized healing abutment can be designed and subsequently fabricated prior to surgically drilling a hole inside the patient's mandibular bone. SUMMARY OF THE INVENTION
[0010] Here in this document, a method of virtually designing a customized healing abutment and guide perforation for a patient is revealed, characterized by the fact that the method comprises:
[0011] - obtain a computed tomography that comprises at least part of the patient's mandibular bone;
[0012] - virtually position at least one implant in relation to the mandibular bone in the computed tomography such that a planned implant placement is defined; and
[0013] - design virtually:
[0014] • a guide drill to guide the surgical drilling of an implant hole within the patient's jaw bone in planned implant placement; and
[0015] • a custom healing abutment configured to conform the soft tissue to a target profile when disposed on the implant;
[0016] in which the design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
[0017] For guide drilling, the guide hole openings through which the surgical bur engages the patient's mandibular bone can be virtually designed based on computed tomography and planned implant placement. Virtual projection can also relate to the portions of the guide perforation that are shaped to arrange the guide perforation correctly in the patient's mouth, for example, in relation to the patient's tooth if the patient has one in their mouth.
[0018] For the custom healing abutment, the shape of the outer surface can be virtually designed based on computed tomography and planned implant placement, where the virtual projection is preferably such that the custom healing abutment can shape the gingiva according to the target profile when disposed in the implant.
[0019] The projection of the guide perforation and the customized healing abutment is based on the same computed tomography as a preoperative computed tomography obtained before surgical perforation inside the patient's mandibular bone as opposed to prior art methods in which a second scan is acquired to virtually design the custom healing abutment.
[0020] The term "computed tomography" is a medical abbreviation often used for Computed Tomography or Computed Axial Tomography which is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional views and 3D images of the structure's internal organs and structures, such as a patient's tooth and mandibular bone. A CT scan can be used to define structures in the structure and/or assist in procedures by helping to precisely guide the placement of instruments or treatments.
[0021] The custom healing abutment is a custom component configured to be disposed relative to a dental implant with the surface facing away from the implant, herein often referred to as the uppermost surface, preferably being substantially flat. The uppermost surface can be substantially flat on its own, as when a screw to secure the custom healing abutment to the implant is an integrated part of the custom healing abutment. When a non-hinged implant screw is used to secure the custom healing abutment to the implant, the uppermost surface defined by the custom healing abutment and the implant screw is preferably substantially flat with the only indentation on the surface being defined by the indentations of the screw.
[0022] When using the expressions "lower" and "upper" to describe the arrangement of objects in relation to the patient's mandibular bone, the expression "lower" is used in relation to the portion of the object facing toward the mandibular bone, while the expression "upper" is used in relation to the portion of the object facing the opposite side of the mandibular bone. That is, when an object such as the custom healing abutment is placed in relation to the patient's upper jaw and the patient is seated, the upper part of the object is closer to the floor than the lower part.
[0023] As will be understood in this document when referring to the different parts, i.e. the guide perforation and the customized healing abutment in relation to the method design as disclosed, it is not a physical part as such, but a virtual representation of a physical part that is described. However, with regard to the final product this will comprise the physical parts that were supplied by manufacturing the specific parts, for example using direct digital manufacturing methods such as 3D printing, based on the virtual representation established during the design process.
[0024] The implant that is virtually placed in relation to the mandibular bone on computed tomography is a virtual representation of a physical implant adapted to replace an original tooth root in the patient's mandibular bone. The virtual representation can, for example, be a CAD model of the implant or an indication of the implant using solid lines or an outline of the implant.
The virtually engineered guide hole is a virtual representation of a physical guide hole adapted to be disposed in the patient's mouth to guide the surgical drilling of a hole inside the patient's mandibular bone. Virtually projecting the guide hole based on the planned implant placement provides the advantage that a physical implant placed in the drilled hole using the fabricated guide hole is arranged according to the planned implant placement. The physical guide hole can be fabricated from the virtual representation of the guide hole using, for example, 3D printing.
[0026] Similarly, the virtually designed custom healing abutment is a virtual representation of a physical custom healing abutment. A physical custom healing abutment fabricated from the virtual representation of the custom healing abutment is adapted to allow the soft tissue in the implant to heal properly prior to attaching a final restoration to the implant. During soft tissue healing, the customized healing abutment prevents the soft tissue from collapsing into the space previously occupied by the extracted tooth, such that when implant osseointegration is completed, the soft tissue is shaped according to the target format.
[0027] When the custom healing abutment is disposed on the implant, its outer surface can engage the soft tissue in the implant and shape it to follow the emergence profile of the custom healing abutment. In some modalities, the emergence profile of the customized healing abutment is at least partially designed based on the target profile. For example, the emergence profile can be set to be identical to the target profile for at least a portion of the soft tissue that engages the surface of the custom healing abutment. The target soft tissue profile can be selected from a library or it can be derived from the shape of an anterior tooth or from the shape of a final restoration designed to be placed in the implant. The target profile can be defined in relation to a geometric axis or a plane of the patient's set of teeth, such as the occlusal plane, a normal to the occlusal plane or to the longitudinal axis of the tooth that the implant and restoration are replaced.
[0028] An advantage of taking planned implant placement into account when virtually designing the guide hole and custom healing abutment is that the guide hole and custom healing abutment can be designed based on a positioning of the implant that is most likely to provide a good anchorage of the implant and therefore the final restoration attached to the patient's jaw bone. Without a CT scan to indicate where a good implant-mandibular bone connection can be achieved, subsequent projection of the guide perforation and custom healing abutment may be far from ideal.
[0029] Consequently, it is an advantage of the method that a customized healing abutment and a guide perforation can be designed virtually, for example, by means of the method that is computer-implemented. It is an advantage that the method can provide a better and faster project result. Furthermore, it is an advantage that the custom healing abutment and guide piercing can be easily manufactured based on virtual designs and the manufacturing cost of the custom healing abutment and guide piercing can be lower than for a healing abutment handcrafted beading and a handcrafted guide punch.
[0030] Consequently, it is an object of the present invention to provide a method, a system and a user interface that provides the possibility to design and manufacture the guide perforation for the dentist along with the customized healing abutment, such that when the hole has been drilled into the patient's mandibular bone assisted by the guide drill, the custom healing abutment is now available and can be inserted into an implant disposed in the drilled hole. This saves the patient a visit to the dentist compared to cases where the customized healing abutment is virtually designed after surgical drilling, for example, based on an additional scan obtained with a scan flag arranged on the implant to derive position and the orientation of the implant in relation to the patient's tooth and/or mandibular bone. In such cases, the patient needs to visit the dentist one more time to have the custom healing abutment inserted into the implant. In addition to taking time from the patient and dentist, this also involves significant additional discomfort when the custom healing abutment is inserted into the implant to replace any temporary component disposed there, such as a mass-produced healing abutment.
[0031] It is an objective of the present invention to provide a method, a system and a user interface for designing a customized healing abutment for the patient.
[0032] It is an object of the present invention to provide a method, a system and a user interface for designing a customized healing abutment for a patient wherein the uppermost surface of the customized healing abutment has a smooth surface.
[0033] Here in this document, a method of virtually designing a customized healing abutment for a patient is revealed, characterized by the fact that the method comprises:
[0034] - obtain a computed tomography that comprises at least part of the patient's tooth that includes the tooth roots;
[0035] - virtually position at least one implant in relation to the tooth of the computed tomography; and
[0036] - Virtually design a custom healing abutment, wherein the custom healing abutment design is at least partially based on computed tomography and virtual implant positioning.
[0037] Consequently, it is an advantage of the method that a customized healing abutment can be designed virtually, for example, by means of the method that is computer-implemented. It is an advantage that the method can provide a better and faster result of the custom healing abutment design. Furthermore, it is an advantage that the custom healing abutment can easily be fabricated based on the virtual design and the manufacturing cost of the customized healing abutment can be less than for a manually manufactured custom healing abutment.
[0038] In a CT scan, the tooth, both the visible part above the soft tissue, such as the gingiva, as the non-visible part, that is, the tooth roots, below the gingiva and mandibular bones and nerves are captured or acquired . However, soft tissue, such as the gums, can also be captured or derived from a CT scan.
[0039] It is an advantage that the customized healing abutment and guide perforation can be designed based on computed tomography comprising the mandibular bone and/or neighboring tooth and on planned implant positioning, for example, position and/ or the orientation, of the implant in relation to the patient's mandibular bone and/or tooth. The virtual design can then be adapted to provide that the custom fabricated healing abutment is aligned and shaped in such a way that it can shape the surrounding soft tissue to the target profile when it is attached to the implant.
[0040] In some embodiments, the implant is placed virtually in position in the patient's dental arch, in which an original tooth used to be, for example, before extraction. That is, the implant is virtually placed in the part of the CT scan where the roots of the original tooth were. This can be advantageous when the mandibular bone is healthy and the implant is arranged to support a restoration with a shape similar to the shape of the original tooth.
[0041] In the patient's mouth the custom healing abutment will be attached to the implant, for example, by means of a screw in the custom healing abutment that is adapted to be threaded into a screw hole in the implant. Alternatively, the implant comprises a screw and the customized healing abutment comprises a screw hole into which the implant screw fits.
[0042] The virtual design of the customized healing abutment and guide drilling can be performed through 3D modeling, which is the process of developing a mathematical and wireframe representation of any three-dimensional objects, called a 3D model, through of specialized software. Models can be created automatically, for example 3D models can be created using multiple approaches: The use of NURBS curves to generate smooth and accurate surface patches, Polygonal mesh modeling which is a manipulation of faceted geometry or subdivision Polygonal mesh that is advanced polygon tessellation, which results in smooth surfaces similar to NURBS models.
[0043] In some embodiments, the method comprises obtaining a 3D surface scan comprising at least part of the tooth and at least part of the soft tissue of the patient's mouth.
[0044] Preferably, the part of the tooth and at least part of the soft tissue of the patient's mouth obtained in the 3D surface scan overlaps at least partially with the computed tomography obtained, i.e., the computed tomography and the 3D surface scan have identical portions captured from the patient's oral cavity.
[0045] It is an advantage to obtain a 3D surface scan of the visible parts of the tooth and gum, due to the fact that the edge between the gum and the tooth can be clearer and more distinct in a 3D surface scan than in a CT scan computerized and the distinct edge between the gingiva and the tooth can make the design of specifically the customized healing abutment easier to perform and with a better result.
[0046] In addition, many commercially available 3D surface scanners, such as the 3Shape TRIOS intraoral scanner, are capable of obtaining data with a higher resolution and spatial accuracy than can be obtained using CT scanners.
[0047] In some embodiments, the method comprises performing a CT alignment and 3D surface scanning before designing the custom healing abutment and/or the guide perforation. The custom healing abutment and/or guide perforation can then be designed based on the aligned CT and 3D surface scans.
[0048] It is an advantage to align the CT scan and the 3D surface scan before designing any components, such as the custom healing abutment and the guide perforation, due to the fact that different information can be derived from different scans and combining the information can result in all possible available information being gathered into one view, which provides an ideal basis for design components.
[0049] In some modalities, the guide perforation is designed based on CT only while the custom healing abutment is designed based on aligned CT and 3D surface scans.
[0050] In some modalities, the custom healing abutment is designed based on CT only while the guide perforation is designed based on aligned CT and 3D surface scans.
[0051] In some modalities, alignment comprises selecting three corresponding points in computed tomography and 3D surface scanning.
[0052] It is an advantage to select and mark, for example, three points in the CT scan and three points in the 3D surface scan that correspond to each other, due to the fact that by means of these corresponding points a rough alignment can be performed.
[0053] In some embodiments, the alignment comprises using the computer-implemented iterative closest-point method. For example, after a coarse alignment has been performed using the corresponding points, a fine adjustment of the coarse alignment using the known interactive closest point (ICP) method can be performed. The nearest interactive point (ICP) is an algorithm used to minimize the difference between two point clouds. ICP can be used to reconstruct 2D or 3D surfaces from different scans, to co-register 3D models, etc. The algorithm interactively reviews the transformation, eg translation and/or rotation, needed to minimize the distance between the points of two raw scans. Inputs to the algorithm are points from two raw scans, the initial estimation of the transformation, the criteria for stopping the iteration. The output is a refined transformation.
[0054] The algorithm steps can be:
[0055] - Points associated by nearest neighbor criteria.
[0056] - Estimate the transformation parameters using a mean square cost function.
[0057] - Transform the points using the estimated parameters.
[0058] - Iterate, that is, re-associate the points and so on.
[0059] In some modalities, computed tomography is a preoperative computed tomography obtained prior to surgical perforation inside the patient's mandibular bone.
[0060] In some modalities, the 3D surface scan is a preoperative 3D surface scan taken prior to surgical drilling into the patient's mandibular bone.
[0061] In cases where the custom healing abutment and guide perforation are designed based on pre-operational CT and 3D surface scans, a physical guide perforation and a physical custom healing abutment can be fabricated from of the virtual designs prior to surgical drilling in such a way that both are ready when surgical drilling is to be performed.
[0062] In some embodiments, the method comprises virtually positioning a final restoration for the implant, that is, virtually positioning the final restoration in relation to computed tomography and/or in relation to 3D surface scanning. The final restoration can be a crown, bridge, or denture designed to be placed on an implant abutment secured to the implant. In some cases, a coping layer is also included either as part of the final restoration or as a layer placed between the implant abutment and the final restoration.
[0063] In some embodiments, the final restoration for the implant is virtually engineered.
[0064] In some embodiments, the final restoration is placed virtually before virtually positioning the implant.
[0065] It is an advantage to virtually place the final restoration before placing the implant and before designing the customized healing abutment, due to the fact that the final restoration is the part that is visible in the patient's mouth and this should therefore be as visually appealing as possible and functionally as good as possible and this can be achieved by placing the final restoration as ideally as possible in the mouth with no restrictions other than the neighboring tooth and antagonist. This can be done by placing the final restoration first, due to the fact that then considerations related to other dental components or parts, such as the implant, abutment, etc., must be made. After the final restoration has been virtually placed, then the implant can be virtually placed to verify that there is sufficient space for the implant between the neighboring tooth roots, nerves, bones, etc. and whether the mandibular bone is healthy and strong enough to support the dental implant. With the final restoration placed relative to the CT mandibular bone and/or relative to the 3D surface scan when virtually positioning the implant, the operator can, for example, also assess which implant placement provides the best possibilities for designing an abutment of implant that can connect the final restoration to the implant. Later, the final restoration can be virtually engineered to provide an improved fit for the implant position and orientation and for the implant abutment or similar.
[0066] In some modalities, the method comprises virtually designing the final restoration, such as a crown, bridge, denture.
[0067] The final restoration can be virtually designed along with the guide perforation and the custom healing abutment. A final restoration fabricated from the virtually engineered final restoration can be a part of the kit comprising the guide perforation and the customized healing abutment.
[0068] In some embodiments, the method comprises using the original tooth shape to design the final restoration, if the original tooth shape is available.
[0069] It can be an advantage to use the original shape of the tooth that the final restoration is replacing, to design the final restoration, when the original tooth can be visually pleasing and fit the other tooth and the patient may prefer the restorations ends look similar to the original tooth so that no one notices that it is a restoration and not the patient's original tooth. The original tooth shape can be derived or obtained from a tooth scan such as a 3D surface scan or a CT scan of the mouth if the tooth is still present or from an old mouth scan or from a 2D image, like a photograph.
[0070] In some embodiments, the final restoration design is at least partially based on the custom healing abutment design.
[0071] It is an advantage to base the design of the final restoration on the design of the custom healing abutment if the custom healing abutment was virtually designed prior to the final restoration. If, for example, the emergence profile of the customized healing abutment is very well designed, then this emergence profile can be used in the design of the final restoration as well.
[0072] In some modalities, the part of the final restoration design that is based on the custom healing abutment design, is the part of the design that has the subgingival present.
[0073] In the context of the present invention, the expressions "subgingival" and "subgingivally" are used in relation to a location below a gingival surface facing the interior of the volume of the oral cavity.
[0074] In some modalities, the final restoration comprises a subgingival portion and the subgingival portion is based on custom healing abutment design
[0075] It is an advantage, for example, if the emergence profile of the customized healing abutment is very well designed, then this emergence profile can be used for the final restoration as well.
[0076] In some embodiments, the method comprises virtually designing a final implant abutment for insertion into the implant, wherein the final restoration is adapted to be attached to the final implant abutment. The final restoration can then be secured to the final abutment in the patient's mouth.
[0077] In some modalities, the method comprises obtaining a second CT scan and/or a second 3D surface scan comprising the customized healing abutment, when placed in the patient's mouth and based on the second CT scan and/or the second 3D surface scan, which adjusts the final restoration design.
[0078] In some cases it is an advantage that after healing from the implant to the mandibular bone, the patient's tooth is swept with the customized healing abutment placed on the implant. After healing in which the implant is integrated into the mandibular bone through osseointegration, the implant may be attached to the mandibular bone a little differently than expected and virtually planned, for example, the implant may have moved a little to one side or it may have sunk deeper into the mandibular bone than expected. This can be detected by scanning the custom healing abutment on the implant and the surrounding tooth, as the position and orientation of the custom healing abutment will provide the position and orientation of the implant. Thus, the design of the final restoration can be adjusted based on the second scan of the customized healing abutment to take the movement of the implant into the bone into account and thus this final design of the final restoration will be as optimal as possible, as the same fits the current situation in the patient's mouth.
[0079] In some modality the guide perforation and the customized healing abutment are designed simultaneously.
[0080] Designing the guide hole and the customized healing abutment simultaneously has the advantage that both components can be fabricated prior to surgically drilling the hole for the implant into the patient's mandibular bone. The guide drilling is used to guide the drilling and when an implant is placed in the drilled hole, the customized healing abutment can immediately be placed on the implant while the patient is still at the dentist. The guide hole and the custom healing abutment can be designed simultaneously, for example, by activating a virtual button on a user interface adapted to design both simultaneously, or the guide hole and the custom healing abutment can be designed sequentially such that one is designed before the other, for example, in visually separate user interfaces on the same visual display unit.
[0081] In some embodiments, the customized healing abutment is adapted to be disposed at least partially in soft tissue that has a desired position and orientation relative to the implant.
[0082] The customized healing abutment can be partially customizable due to the fact that it can be arranged in any desired position and orientation in relation to the implant. The customized healing abutment can have any desired shape such that it can be arranged in any desired position. The shape of the customized healing abutment can, for example, be a non-symmetrical shape. In some cases, the implant may not be disposed in the patient's mandibular bone in such a way that the longitudinal axis of the implant is parallel to the longitudinal axis of the final restoration. Since the soft tissue is preferably shaped according to the final restoration and not an angled implant, the customized healing abutment can in such cases be designed to compensate for the off-axis disposition of the implant such that it can shape the soft tissue to be ready to fit the final restoration. Soft tissue can also be called the gums, sulcus, mucosa, etc.
[0083] In some embodiments, the custom healing abutment design is at least partially based on the design of the final restoration.
[0084] It is an advantage to base the design of the custom healing abutment on the design of the final restoration if the final restoration is designed prior to designing the custom healing abutment. The customized healing abutment can then, for example, shape the soft tissue to a shape that fits the emergence profile of the final restoration.
[0085] In some embodiments, the custom healing abutment design is at least partially based on implant positioning, that is, the position and orientation of the implant in relation to the patient's mandibular bone and/or existing tooth. The placement can be the planned virtual implant placement in which the implant is virtually placed relative to the CT mandibular bone.
[0086] It is an advantage to base the design of the custom healing abutment on implant positioning, that is, the position and orientation, as the custom healing abutment must fit within the implant.
[0087] In some embodiments, the custom healing abutment design is at least partially based on a visible part of the neighboring tooth and/or a non-visible part of the neighboring tooth.
[0088] The customized healing abutment can be placed partially in the soft tissue and partially above the soft tissue, eg above the gums. In soft tissue the customized healing abutment should not touch or collide with the non-visible parts of the neighboring tooth that are also in the soft tissue. Above the soft tissue, the custom healing abutment should not touch or collide with the visible part of the neighboring tooth. The visible part of the neighboring tooth can be seen from CT scan and/or 3D surface scan. The non-visible part of the neighboring tooth can be identified on CT scan.
[0089] In some embodiments, the custom healing abutment design is at least partially based on the soft tissue at the site where the custom healing abutment is adapted to be disposed.
[0090] Thus, if the soft tissue has a specific shape that is important to maintain due to the risk of infections, pain, etc., then the custom healing abutment can be designed to fit and maintain the gingiva in shape. The soft tissue can be represented by a part of the 3D surface scan and/or a part of the CT scan, such that the customized healing abutment is at least partially designed by sharpening part of its external surface according to the parts. values from 3D surface scanning and/or computed tomography.
[0091] In some embodiments, the custom healing abutment design is at least partially based on a target soft tissue profile between the implant and the final restoration. The target profile can be defined by the dentist or dental technician based on a desired shape of the soft tissue between the implant and the final restoration.
[0092] Thus, if the soft tissue around the implant and the final restoration appears or is shaped in a special way, then the custom healing abutment can be designed to provide this soft tissue shape, for example, pushing the gingiva away from a neighboring tooth or allowing the gingiva to move closer to the top of the implant, ie the end of the implant that points towards the restoration and the custom healing abutment.
[0093] The other end of the implant can be called the bottom of the implant, which is the end that points toward the mandibular bone or the roots of the neighboring tooth.
[0094] In some embodiments, the method comprises virtually projecting the emergence profile of the customized healing abutment from the top of the implant to the beginning of the gingiva, that is, to the gingiva surface at the gingiva-air interface. The emergence profile can be shaped according to a target soft tissue profile.
[0095] In some modalities, the method comprises using the original tooth shape to design the customized healing abutment, if the original tooth shape is available.
[0096] It is an advantage to use the original tooth shape to design the custom healing abutment, as the custom healing abutment design can be a compensation or reduction of the original tooth shape, for example, also if the final restoration is a copy of the original tooth, which the restoration is replacing. The original tooth shape can be derived or obtained from a tooth scan such as a 3D surface scan or a CT scan of the mouth if the tooth is still present or from an old mouth scan or from a 2D image, like a photograph.
[0097] In some embodiments, the custom designed healing abutment comprises a substantially flat rounded top.
[0098] It is an advantage to design the custom healing abutment with a flat, rounded top if the custom healing abutment is to be as inconspicuous and non-visible and inconspicuous as possible in the patient's mouth. The gingiva can also gently heal around a flat, rounded shape so that the gingiva is in good shape when the final restoration is inserted later. A flat rounded top also ensures that food and other materials are not trapped, which could occur if there is a depression in the top.
[0099] In some embodiments, an uppermost surface of the custom healing abutment comprises an opening to accommodate the screw head of an implant screw through which the custom healing abutment must be attached to an implant and the custom healing abutment is designed to provide a smooth transition from the custom healing abutment to the implant screw.
[00100] The smooth transition can be such that no side wall of the opening is visible when the implant screw is disposed relative to the custom healing pin, i.e., the screw head completely covers the side wall of the opening and the Screw head side wall cannot be seen. The smooth transition can be such that the uppermost surfaces of the custom healing abutment and implant screw head are in the same plane when the implant screw is disposed relative to the custom healing abutment.
[00101] In some embodiments, the information is related to the height of the implant screw head and where the opening of the custom healing abutment is shaped to provide that the transition from custom healing abutment to implant screw is smooth.
[00102] In some modalities, custom healing abutment projection comprises setting the height of the opening in the screw head at a value that provides that the screw head does not extend above the uppermost surface of the custom healing abutment or vice versa. versa.
[00103] In some embodiments, the information is related to the length of the implant screw and where the custom healing abutment is designed to have a length that provides that the transition from the custom healing abutment to the implant screw is smooth.
[00104] In some embodiments, the custom healing abutment is designed to have a height that is within a range defined by the screw length.
[00105] In some embodiments, the custom healing abutment is virtually designed in such a way that it is configured to conform soft tissue according to a target profile when disposed on the implant.
[00106] In some embodiments, the method comprises virtually positioning at least one implant in relation to the mandibular bone on computed tomography such that a planned implant placement is defined.
[00107] In some embodiments, the custom healing abutment is designed to be flush with the surrounding soft tissue, that is, the top surface of the custom healing abutment is flush with the soft tissue surface.
[00108] It is an advantage with a custom healing abutment top that is flush with the surrounding soft tissue, for example the gingiva, due to the fact that then the custom healing abutment can be more or less invisible when in patient's mouth.
[00109] In some embodiments, the custom healing abutment is designed to have a predetermined height in relation to the surrounding soft tissue.
[00110] The custom healing abutment can be designed to have a predetermined height in relation to the level of the gingiva, where the top of the custom healing abutment is below the level of the gingiva, such that the custom healing abutment is invisible when in the patient's mouth. When replacing the custom healing abutment with the final restoration, the gingiva above the custom healing abutment can be cut to remove the custom healing abutment. Alternatively, the custom healing abutment can be designed such that its top is above the level of the gingiva, for example if it is uncertain how the gingiva will heal around the custom abutment, then to be on the safe side, the top of the custom healing abutment can be designed to be above the gingival level to better target gingival healing.
[00111] In some embodiments, the custom healing abutment design is not adapted for attaching a temporary crown or other temporary restoration. In some cases the custom healing abutment should only be placed on the implant during the healing period and no restorations should be attached to the custom healing abutment and/or implant. Healing and fixation of the implant in the mandibular bone can be improvised if the implant is not affected by any forces during healing. Thus, if no temporary restoration is attached, then no forces such as chewing food or the like should affect the implant. The customized healing abutment can, for example, have a smooth surface above the gingiva such that a temporary crown or other temporary restoration cannot be attached to it.
[00112] In some embodiments, the custom healing abutment design comprises scanning markers to derive implant position and orientation information when scanning the custom healing abutment on the implant. The customized healing abutment can, for example, be swept before and while being inserted into the implant in the patient's mouth. The mouth scan also acquires data related to at least a part of the patient's mandibular bone and/or tooth and/or soft tissue, such that the placement of the customized healing abutment in relation to the mandibular bone and/or tooth and/or soft tissue can be obtained. The customized healing abutment comprising the scan markers can, for example, be scanned after implant healing, such that the position and orientation of the implant is fixed and such that the gingiva around the healing abutment custom has healed. Due to the scan markers on the custom healing abutment, exact positioning, i.e. the position and orientation, of the implant in the mandibular bone can be achieved when the custom healing abutment is placed on the implant and swept in such a way that scan markers are captured.
[00113] The attachment of the custom healing abutment to the implant can be well defined such that by sweeping the scan marker on the custom healing abutment the exact position and orientation of the implant in the mandibular bone can be obtained. The length of the custom healing abutment measured from, for example, the top of the implant to the highest point on the custom abutment away from the gingiva can be preset or measured when the custom healing abutment is designed such that the implant depth in soft tissue can be calculated when scanning the markers on the custom healing abutment.
[00114] In some modalities, the sweep markers and their position on the custom healing abutment are virtually designed to match the custom healing abutment such that the sweeping markers are designed for the specific custom healing abutment.
[00115] Since the customized healing abutment is customized and unique, the scan markers can or should also be more or less customized.
[00116] In some embodiments, the method comprises virtually positioning the implant.
[00117] In some embodiments, the implant is virtually placed after virtually positioning the final restorations.
[00118] In some embodiments, the method comprises virtually designing the insertion of the implant into the patient's mouth. That is, a virtual plane or guide for the insertion can be designed, ie as: the implant must be inserted downwards at an angle to the plane of occlusion of 2 degrees etc.
[00119] In some embodiments, the method comprises using the original tooth shape to project the planned implant placement, that is, the planned implant position and orientation, if the original tooth shape is available. Implant position and orientation may be relative to the patient's jaw bone and/or tooth.
[00120] It is an advantage to use the original tooth shape that the implant and final restoration are replaced, to design the implant, due to the fact that the length, thickness, position and orientation of the original tooth root can be useful for implant design, which to some extent can resemble or replace a tooth root. The original tooth shape can be derived or obtained from a tooth scan, such as a CT scan or a 3D surface scan of the mouth if the tooth is still present, or from an old mouth scan.
[00121] In some modalities, the virtual implant design provides that the implant is adapted to be inserted into the patient's mandibular bone with the planned implant positioning, that is, the planned implant position and orientation, which is such that the implant is not placed into a tooth root from another tooth or into a nerve.
[00122] In this way, the implant does not have to be inserted in a straight vertical orientation, but can be inserted with a small, medium or large angle to the vertical.
[00123] In some embodiments, the method comprises virtually performing collision detection of the implant with respect to the roots of the neighboring tooth or the implants.
[00124] It is an advantage to perform a virtual test for collision detection between the planned positioning of the virtual implant and the roots and nerves of the neighboring tooth to verify that there is free space for the implant when the implant positioning is virtually planned and, for example, also implant design. The position of the roots and nerves of the neighboring tooth can be determined from the computed tomography obtained. The insertion can be virtually engineered, for example, starting from an initial insertion trajectory and performing collision detection to determine if the implant can be moved into a planned position without collisions with the neighboring tooth. If collision detection indicates that collisions will occur along the initial insertion trajectory, a new trajectory can be determined and tested for collision. This continues until a suitable collision-free path is identified.
[00125] In some embodiments, the method understands that it provides virtually limitations for the implant in relation to the visible part of the neighboring tooth.
[00126] Thus, the visible part of the neighboring tooth can also impose limitations on the position and/or orientation and/or implant design. The limitation can, for example, be related to a maximum acceptable angle of the implant's longitudinal axis in relation to the normal of the occlusal plane of the patient's set of teeth. It may be an advantage to define such a maximum acceptable angle in relation to the occlusal plane in order to obtain a good mechanical functionality of the implant and of the final restoration arranged in the implant.
[00127] In some embodiments, the method comprises virtually planning the surgical drilling of the hole for the implant.
[00128] When the implant position and/or orientation has been virtually projected, then a virtual planning of the surgical drilling can be performed.
[00129] In some embodiments, the method comprises virtually designing a guide perforation for the implant perforation.
[00130] When the implant position and/or orientation has been designed and/or when virtual planning of the surgical drilling has been done, then a guide hole can be designed virtually. A guide perforation can be an advantage to use for the dentist to ensure that the implant is correctly placed in the mandibular bone in accordance with the planned placement and that the custom healing abutment fits.
[00131] In some modalities, the virtual planning of the surgical perforation and/or the virtual design of the guide perforation is/are designed based on computed tomography.
[00132] It is an advantage to use a CT scan for this, as tooth roots can be seen on a CT scan.
[00133] In some modalities, the surgical drilling virtual planning and/or the guide drilling virtual design is/are designed based on the 3D surface scan.
[00134] It is an advantage to use the 3D surface scan for this, as the visible part of the neighboring tooth can be seen and the edge of the gingival can be derived from this scan, which is used to advantageously in the virtual planning of the surgical perforation and in the virtual guide drilling project.
[00135] In some modalities, the method comprises extracting virtually any tooth that is placed where an implant is planned to be placed.
[00136] It is an advantage to virtually extract the tooth, so that the virtual view of the mouth appears as it will, more or less, as when the dentist starts physical placement of the implants, due to the fact that, in this way, implant placement can be virtually planned and the final restoration and customized healing abutment can be virtually designed, under conditions that reflect or match the physical conditions in the patient's mouth.
[00137] In some modalities, the method comprises virtually projecting the soft tissue that surrounds the customized healing abutment.
[00138] In this way, the soft tissue, for example the gums, around the custom healing abutment can be designed to a desired appearance and the custom healing abutment can then, for example, be designed to fit the design of the soft tissue.
[00139] In some embodiments, the method comprises virtually projecting the soft tissue surrounding the custom healing abutment using the original soft tissue shape from CT and/or 3D surface scanning.
[00140] Thus, it is an advantage to obtain a soft tissue scan, for example the gums, around the planned implant and the planned custom healing abutment, before any teeth are extracted and before the implant is placed, due to fact that the gingiva will likely look good at this point and the intact and undamaged gingiva can then form the basis for gingiva design after the implant, custom healing abutment and/or final restoration have been placed.
[00141] In some modalities, the custom healing abutment design is configured for coupling a temporary restoration to the custom healing abutment.
[00142] In some cases, for example, if the implant and final restoration are to replace an anterior tooth, then a temporary restoration can be attached to the customized healing abutment, due to the fact that it may not be visually appealing without a front tooth for the perhaps long period when the implant is healing.
[00143] In some embodiments, the custom healing abutment design comprises means for attaching a temporary restoration such as a temporary crown or a temporary bridge.
[00144] The means for attachment can be a hole in the top of the customized abutment, for example, to attach a temporary retinal screw restoration. Or the temporary coupling can be coupled through cementation or bonding the temporary restoration to the custom healing abutment.
[00145] If a temporary restoration is attached to the custom healing abutment, then the temporary restoration can be designed not to be at the level of the neighboring tooth, but to be lower than the neighboring tooth, such that the risk of affecting the abutment of customized healing with the forces of collision with the antagonist or with food, is minimized.
[00146] In some embodiments, the custom healing abutment comprises a screw hole to retain the temporary restoration such as a temporary crown. This may be the case when the temporary restoration is equipped with a screw configured to engage the screw hole.
[00147] In some embodiments, the temporary restoration, such as a temporary crown, is adapted to be cemented to the custom healing abutment such that the temporary restoration can be efficiently secured to the custom healing abutment until the implant has healed to the bone mandibular.
[00148] In some embodiments, the method comprises virtually designing a temporary restoration for attachment to the custom healing abutment.
[00149] The temporary restoration may comprise a stock abutment and a crown or a screw-retained crown or a two-piece restoration comprising a coping and a crown on the custom healing abutment or a one-piece restoration comprising a crown on the customized healing abutment.
[00150] For the stock abutment, the customized healing abutment can be the stock abutment.
[00151] The parts or components of the temporary restoration, for example, coping etc., can also be customized due to the fact that the customized healing abutment is unique, so the other components attached to it can or should also be customized to fit and match the custom healing abutment.
[00152] Computed tomography and/or 3D surface scanning captures at least part of the mandibular or maxillary or at least a part of both of the patient.
[00153] In some embodiments, computed tomography is a cone beam computed tomography (CBCT).
[00154] In some embodiments, the 3D surface scan is an intraoral scan captured directly in the patient's mouth and/or a scan of a physical impression of the patient's tooth/gums and/or a scan of a physical model of the tooth/gums of the patient.
[00155] It is observed that in this application the scanning of the tooth and the customized healing abutment coupled to the implant was described. Scanning can be performed by performing a CT scan. However, it may also be an advantage to perform a 3D intraoral scan directly into the patient's mouth using an intraoral scanner. However, instead of performing intraoral scanning directly, an impression of the patient's tooth and/or custom healing abutment disposed in the implant can be obtained and the custom healing abutment in the impression can then be an analogue. The print can be scanned on a 3D desktop scanner suitable for scanning prints However, a physical model of the tooth can be made by molding the model from the print and the physical model can then be scanned on a 3D desktop scanner suitable for scanning teeth models.
[00156] The intraoral scanner can be configured to use focus scanning, in which the 3D digital representation of the scanned tooth is reconstructed from in-focus images acquired at different focus depths. The focus scanning technique can be performed by generating a probe light and transmitting that probe light towards the set of teeth such that at least a portion of the set of teeth is illuminated. Light returning from the set of teeth is transmitted towards a camera and imaged on an in-camera image sensor by means of an optical system, wherein the image sensor/camera comprises an array of sensor elements. The position of the focus plane in/in relation to the set of teeth is varied by means of optical focusing elements while images are obtained from/by means of said array of sensor elements. Based on the images, the focus position(s) of each of a plurality of sensing elements or each of a plurality of groups of sensing elements can be determined for a sequence of focus plane positions.
[00157] The position in focus can, for example, be calculated by determining the amplitude of light oscillation for each of a plurality of sensing elements or each of a plurality of groups of sensing elements for a range of focus planes . From the focus positions, the digital 3D representation of the tooth set can be derived.
[00158] Obtaining a three-dimensional representation of the surface of an object by sweeping the object in, for example, a 3D table scanner can be denoted 3D modeling, which is the process of developing a mathematical representation of the three-dimensional surface of the object through specialized software. The product is called a 3D model. A 3D model represents the 3D object using a collection of points in 3D space, connected through various geometric entities such as triangles, lines, curved surfaces, etc. The purpose of a 3D scanner is usually to create a cloud of geometric sample points on the surface of the object.
[00159] 3D scanners collect distance information about surfaces within their field of view. The "engraving" produced by a 3D scanner describes the distance to a surface at each point in the engraving.
[00160] For most situations, a single scan or sub-scan will not produce a complete model of the object. Multiple subscans such as 5, 10, 12, 15, 20, 30, 40, 50, 60, 70, 80, 90 or in some cases even hundreds from different directions may be required to get information on all sides of the object. These subscans are brought into a common reference system, a process that might be called alignment or registration, and then joined together to create a complete model.
[00161] A triangulation 3D laser scanner uses the laser light to scan the environment or object. A triangulation laser shines a laser at the object and uses a camera to look for the location of the laser point. Depending on how far the laser hits a surface, the laser dot appears in different places in the camera's field of view. This technique is called triangulation because the laser dot, camera, and laser emitter form a triangle. A laser strip, rather than a single laser dot, can be used and is then dragged across the object to speed up the acquisition process.
[00162] Structured 3D light scanners project a light pattern onto the object and observe the deformation of the pattern on the object. The pattern can be one-dimensional or two-dimensional. An example of a one-dimensional pattern is a line. The line is projected onto the object using, for example, an LCD projector or a drag laser. A camera slightly offsets the pattern projector, observes the shape of the line, and uses a technique similar to triangulation to calculate the distance of all points on the line. In the case of a single-line pattern, the line is dragged across the field of view to gather distance information one strip at a time.
[00163] An example of a two-dimensional pattern is a grid or line stripe pattern. A camera is used to observe the pattern's deformation and an algorithm is used to calculate the distance at each point in the pattern. Algorithms for multi-strip laser triangulation can be used.
[00164] In some embodiments, the method comprises virtually designing a radiographic template adapted for positioning on the patient's tooth to simulate the implant position and/or the final restoration.
[00165] In some embodiments, the method comprises obtaining a computed tomography and/or a 3D surface scan of a radiographic template disposed on the patient's tooth. It is an advantage to design a radiographic template to be placed on the patient's tooth, such as in the patient's mouth, due to the fact that when sweeping the tooth and template, the final restoration design can be translated to or used or viewed together with the patient's existing tooth. Where there is no tooth, the radiographic template can rest directly on the jaw in the patient's mouth. Instead of an intraoral scan, an impression or a physical model of the patient's tooth can be produced and scanned. The radiographic template may contain a material that can be specifically captured by a CT scan, such as barium.
[00166] In some embodiments, at least one of the method steps is computer-implemented.
[00167] In some modalities, virtually positioning the implant and virtually designing the customized healing abutment are performed as part of an iterative process in which each iterative process iteration comprises evaluating implant placement and/or abutment design of customized healing and based on an assessment result that determines whether implant placement and/or customized healing abutment design need to be modified. The assessment of implant placement can be in relation to the support provided by the patient's mandibular bone, that is, how much bone material is available to hold the implant and whether the mandibular bone is healthy. The assessment of implant placement can also be with respect to whether it is possible to drill the hole into the patient's mandibular bone in the planned implant placement. The neighboring tooth may be obstructing in such a way that there is not enough space for the dentist to place the surgical drilling tool in an appropriate position in relation to the patient's tooth and mandibular bone. The assessment of implant placement can also be based on the expected mechanical strength of the implant when placed in the patient's mandibular bone. A large compensation from the normal to the occlusal plane can, for example, introduce problems due to forces applied to the implant during chewing.
[00168] In some modalities, the evaluation of the iterative process takes into account the design of the final restoration.
[00169] When disposed in the patient's mandibular bone, the implant will ultimately form the support for the final restoration, for example, through an implant abutment and it is therefore advantageous to ensure that the planned implant placement is adequate to support the final restoration. The customized healing abutment preferentially shapes the soft tissue according to a target profile that fits the final restoration. As such, it is an advantage to take the final restoration design into account when evaluating the custom healing abutment design.
[00170] In some embodiments, virtually designing the final restoration is part of the iterative process and where the assessment determines whether the final restoration design needs to be modified.
[00171] This provides the advantage that the dentist can determine whether a current final restoration design will place unwanted limitations on the custom healing abutment design and planned implant placement. For example, a current final restoration design may require very high precision, for example, in implant positioning such that problems arise if deviations in implant positioning are introduced through surgical drilling or osseointegration. A current final restoration design may also limit the range of possible designs of the customized healing abutment unnecessarily.
[00172] In some modalities, implant placement is modified based on the custom designed healing abutment and/or based on the final designed restoration.
[00173] In some cases, an adjustment in implant placement is acceptable as long as the dentist prefers to keep a chosen final restoration design, for example, if the design fits the shape of an extracted tooth. Similarly, the dentist may have a preferred shape of the custom healing abutment and want to maintain that shape while being prepared to accept some modification of implant placement.
[00174] In some embodiments, the custom healing abutment is redesigned based on modified implant placement and/or based on the final designed restoration.
[00175] In some cases, some adjustments to the custom healing abutment design are acceptable and the dentist prefers to maintain a chosen design of the final restoration. Equally, the dentist may have a preferred implant placement after having consulted the CT scan and wish to maintain that placement while willing to allow for some modifications to the custom healing abutment design.
[00176] In some modalities, the iterative process comprises the redesign of the final restoration based on the modified implant placement and/or redesigned custom healing abutment.
[00177] The redesign of the final restoration can have the advantage that it is much easier to achieve the planned implant placement in the patient's mandibular bone and that the redesigned custom healing abutment is much easier to manufacture.
[00178] In some embodiments, the guide drilling is virtually designed based on the planned implant placement after the last iteration of the iterative process. This can ensure that when the dentist uses the guide drill while surgically drilling the hole in the patient's jaw bone, the hole is in an optimal position and orientation in relation to the planned implant placement.
[00179] The present invention relates to different aspects, which include the method described above and below and corresponding methods, devices, apparatus, systems, products, uses, kits and/or product means, each yielding one or more of the benefits and advantages described in connection with the first mentioned aspect and each having one or more embodiments corresponding to the embodiments described in connection with the first mentioned aspect and/or disclosed in the appended claims.
[00180] In particular, disclosed herein is a method for designing and virtually planning an implant procedure for a patient, the method comprising designing a customized healing abutment for the implant and a guide hole for surgically drilling a hole for implantation in the patient's mandibular bone, where the method comprises:
[00181] - obtain a computed tomography of at least part of a patient's mouth;
[00182] - virtually position one or more implants adapted to replace at least part of the non-visible part of the one or more original teeth, such that a planned implant placement is defined;
[00183] - virtually designing one or more customized healing abutments adapted to insert into the one or more implants and to conform the surrounding soft tissue according to a target profile;
[00184] - to virtually design a guide hole adapted for surgical drilling of holes for the implants in the patient's bone through the guide hole, in which the guide hole is designed to ensure that the holes are such that the implants are placed in the holes are laid out according to the planned implant placement and the custom healing abutments can form the soft tissue according to the target profile when laid out on the implant.
[00185] In some embodiments, the method comprises providing virtually guiding limitations for positioning the implants and/or virtually testing and providing warnings of implant collision with other implants or tooth roots.
[00186] In some embodiments, the method comprises virtually positioning one or more final restorations adapted to replace the visible part of one or more original teeth, wherein the original tooth is adapted to be extracted.
[00187] In particular, a method for designing and virtually planning an implant procedure for a patient is disclosed in this document, wherein the method comprises designing a guide perforation and a customized healing abutment for the implant, wherein the method comprises :
[00188] - obtain a 3D surface scan of at least part of a patient's mouth;
[00189] - obtain a computed tomography of at least part of a patient's mouth;
[00190] - virtually align 3D surface scanning and computed tomography;
[00191] - virtually position one or more final restorations adapted to replace the visible part of the one or more original teeth, in which the original tooth is adapted to be extracted;
[00192] - virtually position one or more implants adapted to replace at least a part of the non-visible part of the one or more original teeth;
[00193] - provide virtually guide limitations for implant placement;
[00194] - virtually test and provide implant collision warnings with other implants or tooth roots;
[00195] - virtually design one or more custom healing abutments adapted for insertion into one or more implants;
[00196] - virtually design one or more abutments of final implants adapted for insertion into the one or more implants;
[00197] - design virtually to one or more virtually placed final restorations adapted for coupling to one or more final implant abutments.
[00198] - Virtually design a guide hole adapted to drill holes for the implants in the patient's bone through the guide hole.
[00199] The visible part of the original tooth can be replaced by the final restorations in computed tomography virtually aligning the final restorations with computed tomography.
[00200] Optionally, the CT scan is also aligned with a 3D surface scan to provide more information regarding, for example, the soft tissue and tooth surface.
[00201] In particular, a method for fabricating a guide perforation is disclosed in this document, wherein the guide perforation is virtually designed using the method according to any of the modalities.
[00202] For example, the virtual guide drilling design can be designed based on CT scan and/or the virtual guide hole design can be designed based on a 3D surface scan.
[00203] In particular, a method for manufacturing a customized healing abutment is disclosed in this document, wherein the customized healing abutment is virtually designed using the method according to any of the modalities.
[00204] In particular, a system for virtually designing a customized healing abutment and guide perforation for a patient is disclosed here, wherein the system comprises:
[00205] - means for obtaining a computed tomography that comprises at least a part of the patient's mandibular bone;
[00206] - means for virtually positioning at least one implant relative to the computed tomography mandibular bone such that a planned implant placement is defined;
[00207] - means to design virtually:
[00208] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in planned implant placement; and
[00209] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant,
[00210] in which the design of the guide perforation and the customized healing abutment is at least partially based on computed tomography and planned implant positioning.
[00211] In particular, a system for virtually designing a customized healing abutment for a patient is disclosed in this document, wherein the system comprises:
[00212] - means for obtaining a computed tomography comprising at least a portion of the patient's tooth including tooth roots;
[00213] - means for virtually positioning at least one implant relative to the computed tomography tooth, wherein the physical implant is adapted to replace an original tooth root in the patient's mandibular bone;
[00214] - means to virtually design a custom healing abutment, wherein the custom physical healing abutment is adapted for insertion into the implant to allow the soft tissue in the implant to heal properly prior to attaching a final restoration to the implant and where the custom healing abutment design is at least partially based on computed tomography and virtual implant positioning.
[00215] The medium can be a processing medium in a computer, such as a processor.
[00216] Furthermore, the invention is related to a computer program product comprising a program code means to make the data processing system perform the method according to any of the modalities, when said means of program code is executed in the data processing system and a computer program product, which comprises a computer readable medium which has the program code medium stored therein.
[00217] In some embodiments, the system comprises a non-transient computer readable medium that has one or more computer instructions stored therein, where said computer instructions comprise instructions for performing a method to virtually design a customized healing abutment and a guide perforation for a patient, where the method comprises:
[00218] - obtain a computed tomography that comprises at least a part of the patient's mandibular bone;
[00219] - virtually position at least one implant in relation to the mandibular bone of the computed tomography, such that a planned implant placement is defined;
[00220] - design virtually
[00221] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and
[00222] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant,
[00223] in which the design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00224] A non-transient computer-readable medium that stores a computer program therein is disclosed, wherein said computer program is configured to cause a computer-assisted method to virtually design a customized healing abutment for a patient , in which the method comprises:
[00225] - obtaining a computed tomography that comprises at least a part of the patient's tooth that includes the tooth roots;
[00226] - virtually position at least one implant relative to the computed tomography tooth, wherein the physical implant is adapted to replace an original tooth root in the patient's mandibular bone;
[00227] - virtually design a custom healing abutment, where the custom physical healing abutment is adapted for insertion into the implant to allow the soft tissue in the implant to heal properly prior to attaching a final restoration to the implant and where the custom healing abutment design is at least partially based on computed tomography and virtual implant positioning.
[00228] A non-transient computer-readable medium that stores a computer program therein is disclosed, wherein said computer program is configured to cause a computer-assisted method to virtually design a customized healing abutment and a perforation -guide for a patient, in which the method comprises:
[00229] - obtain a computed tomography that comprises at least a part of the patient's mandibular bone;
[00230] - virtually position at least one implant in relation to the computed tomography mandibular bone in such a way that a planned implant placement is defined;
[00231] - design virtually:
[00232] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and
[00233] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant
[00234] in which the design of the guide perforation and the customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00235] A user interface for virtually designing a custom healing abutment and guide perforation for a patient is revealed, where the user interface is configured to:
[00236] - obtain and view a computed tomography that comprises at least a part of the patient's mandibular bone;
[00237] - virtually position at least one implant in relation to the computed tomography mandibular bone in such a way that a planned implant placement is defined; and
[00238] - design virtually:
[00239] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and
[00240] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant
[00241] in which the design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00242] In some embodiments, the user interface is configured to obtain and view a 3D surface scan comprising at least a portion of the tooth and soft tissue of the patient's mouth.
[00243] In some embodiments, the user interface is configured to perform a CT alignment and 3D surface scan before designing the custom healing abutment and guide perforation.
[00244] In some embodiments, the user interface is configured to virtually position a final restoration for the implant relative to computed tomography and/or relative to 3D surface scanning and to virtually design the final restoration. In the patient's mouth, the final restoration can be connected to the implant via an implant abutment. In the user interface, it is not necessary to view such an implant abutment.
[00245] In some embodiments, the user interface is configured to virtually position the final restoration before virtually positioning the implant.
[00246] In some embodiments, the user interface is configured to be viewed by an operator using a computer screen and to allow the operator to enter data and make choices presented on the user interface via a computer keyboard or a computer mouse.
[00247] In some embodiments, the user interface is configured to view the implant along with CT scan and optionally the 3D surface scan and user interface comprises a virtual tool to perform custom healing abutment design and guide drilling when activated.
[00248] A kit comprising a customized healing abutment and a guide perforation for a patient is disclosed, wherein the kit comprises:
[00249] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and
[00250] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant
[00251] in which the guide hole and the custom healing abutment are configured to provide that an implant disposed in a hole drilled using the guide hole is placed in the planned implant placement such that the custom healing abutment can form the soft tissue according to the target profile when disposed in the implant.
[00252] A method for virtually designing a customized healing abutment for a patient is disclosed, wherein the method comprises:
[00253] - obtain a computed tomography that comprises at least a part of the patient's mandibular bone;
[00254] - obtain information regarding an implant screw by which the customized healing abutment must be coupled to an implant, wherein the implant screw comprises a screw head; and
[00255] - virtually design a custom healing abutment that takes implant screw information into account, where a more upper surface of the custom healing abutment is designed to comprise an opening to accommodate the screw head and in which the abutment Custom Healing Abutment is designed to provide a smooth transition from the custom healing abutment to the implant screw. BRIEF DESCRIPTION OF THE DRAWINGS
[00256] The above and/or additional objectives, features and advantages of the present invention will be further elucidated by the following detailed description of illustrative and non-limiting embodiments of the present invention, with reference to the attached drawings, characterized in that:
[00257] Figure 1 shows a flowchart of a method for virtually designing a customized healing abutment for a patient.
[00258] Figure 2 shows schematic examples of custom healing abutments.
[00259] Figure 3 shows schematic examples of an implant abutment and a final restoration in an implant.
[00260] Figure 4 shows a schematic example of an implant with a final restoration in a patient's mandible.
[00261] Figure 5 shows schematic examples of final implant restorations.
[00262] Figure 6 shows schematic examples of different relationships of a customized healing abutment in relation to the gingiva.
[00263] Figure 7 shows an example of a flowchart of a method for virtually designing an implant, a restoration and more for a patient.
[00264] Figure 8 shows an example of a screen view of a computed tomography of a set of patient teeth.
[00265] Figure 9 shows an example of a CT scan and a 3D surface scan, which are aligned.
[00266] Figure 10 shows an example of a CT scan in which a nerve is seen.
[00267] Figure 11 shows an example of virtually positioning a final restoration for an implant.
[00268] Figure 12 shows an example of a CT scan in which an implant is virtually placed.
[00269] Figure 13 shows examples for virtually designing an abutment and restoration for an implant.
[00270] Figure 14 shows an example of a guide hole fabricated to drill holes for implants in the patient's jaw.
[00271] Figure 15 shows an example of a custom healing abutment with scan markers.
[00272] Figure 16 shows a schematic drawing of a system to implement the embodiments of the present invention.
[00273] Figure 17 shows flowcharts of embodiments of the method of the invention.
[00274] Figure 18 shows a schematic drawing of a procedure for replacing a tooth with a dental restoration and an implant.
[00275] Figure 19 shows a flowchart for a treatment of a patient that provides the patient with a final implant-based restoration.
[00276] Figure 20 shows a custom healing abutment design where the transition to the implant screw is smooth. DETAILED DESCRIPTION
[00277] In the following description, reference is made to the attached Figures, which show by way of illustration how the invention can be practiced.
[00278] Figure 18 shows a schematic drawing of a procedure for replacing a tooth with a dental restoration and an implant.
[00279] Figure 18a shows three of the teeth of the patient 1812, 1813, 1881 in which tooth 1881 in the middle must be extracted and replaced by an implant and a final restoration, for example, due to the fact that the tooth is dead and have become fragile. Subgingivally, that is, below the surface of gingiva 1805, the teeth have cervical portions 1882 which engage the patient's mandibular bone 1811 such that the tooth is held firmly in the patient's mouth. The dotted lines in the Figure represent subgingival elements.
[00280] Immediately after tooth 1881 is extracted, the space formerly occupied by extracted tooth 1881 forms an 1883 hole in the 1805 gum between teeth 1812, 1813. A hole is drilled in the 1811 mandibular bone at this 1883 hole and an 1804 implant is arranged in the hole as shown in Figure 18b.
[00281] To prevent soft tissue from collapsing at hole 1883, a healing abutment 1801 is connected to implant 1804 in such a way that the outer surface of healing abutment 1801 can act as a support for gingiva 1805 during osseointegration of the 1804 implant in the mandibular bone. The healing abutment 1801 illustrated in Figure 18c has a flattened upper surface, however, other geometries are also acceptable and the surface may have an opening for an implant screw.
[00282] When osseointegration is complete, the healing abutment is removed and replaced with an 1806 implant abutment configured to support a final restoration as illustrated in Figure 18d. The implant abutment is designed here to have an 1884 margin line just below the surface of the 1805 gingiva.
[00283] Figure 18e shows the final restoration 1807 designed to be placed on the implant abutment. The final 1807 restoration has an 1886 outer surface that is shaped to an anatomically desirable tooth shape, such as the shape of the original tooth if the patient was satisfied with that shape, and an abutment that engages the shaped 1887 surface to allow for the restoration. end is disposed on the implant abutment. The tooth 1888 margin line is designed to fit the margin line of the implant abutment.
[00284] Figure 18f illustrates the patient's tooth with the extracted tooth replaced by the final restoration 1807 disposed in the implant 1804 through the implant abutment 1806. The implant is secured in the mandibular bone 181 1 such that the final restoration 1807 is secured firmly in the patient's mouth. Final restoration 1807 is shaped to provide an esthetic appearance alongside the surrounding teeth 1812, 1813.
[00285] Figure 1a shows a flowchart of the method for virtually designing a customized healing abutment for a patient.
[00286] In step 101a, a CT scan comprising at least a portion of the patient's mandibular bone and the tooth including the tooth roots is obtained.
[00287] In step 102a, at least one implant is virtually placed in relation to the mandibular bone and tooth of the CT scan. The virtual implant corresponds to a physical implant, where the physical implant is adapted to replace an original tooth root in the patient's mandibular bone.
[00288] In step 103a, a custom healing abutment is virtually designed. A custom healing physical abutment can be fabricated from custom virtual healing abutment counterparts, where the custom healing physical abutment is adapted for insertion into the implant to allow the soft tissue in the implant to heal properly before attaching a final restoration in the implant. The custom healing abutment design is at least partially based on CT and virtual implant positioning.
[00289] A step of virtually positioning a final restoration for the implant in relation to the CT mandibular bone can be performed before the step 102a of virtually positioning the implant, such that the positioning of the implant takes into account a desired shape and positioning of the final restoration.
[00290] Figure 1b is a flowchart of the method for virtually designing a custom healing abutment and guide perforation for a patient.
[00291] In step 101b, a CT scan comprising at least a portion of the patient's mandibular bone is obtained.
[00292] In step 102b, at least one implant is virtually placed relative to the mandibular bone on the CT scan such that a planned implant placement is defined.
[00293] In step 103b, it is virtually projected:
[00294] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in the planned implant placement; and
[00295] • a custom healing abutment configured to conform the soft tissue to a target profile when disposed on the implant;
[00296] The design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00297] Figure 2 shows schematic examples of customized healing abutments.
[00298] Figure 2a) shows an example of a custom healing abutment 201 comprising a top over part 202 and a screw part 203. The top part 202 is the part configured to emerge from the implant edge through of soft tissue and potentially passes through the gingiva to be visible above the gingiva next to the neighboring tooth. Gum position 205 is indicated.
[00299] Figure 2b) shows an example of a custom healing abutment 201 arranged on an implant 204. The screw part 203 of the custom healing abutment is screwed onto the implant 203. The top part 202 protrudes from the implant 204.
[00300] Figure 2c) shows an example of a custom healing abutment 201 disposed in an implant 204, where the implant is disposed in the patient's mandibular bone with an angle of inclination in relation to the vertical, where the horizontal or normal is indicated by gingiva 205. Screw portion 203 and top portion 202 of custom healing abutment 201 have a boundary, relative to each other, perpendicular to the longitudinal geometric axis of the implant. However the boundary between the top part and the screw part of the custom healing abutment can alternatively be flush with the gingiva, or somewhere between being flush with the gingiva and being perpendicular to the longitudinal geometric axis of the implant. The screw portion of the customized healing abutment, however, should only be able to be screwed into the implant.
[00301] In Figures 2a) and 2b), the boundary between the top part and the screw part of the customized healing abutment is indicated by being level with the gingiva, however, it is understood that the customized healing abutment and gingiva they can be in contact anywhere along the custom healing abutment.
[00302] In Figure 2c), the contact between the custom healing abutment and the gingiva is at the boundary between the top part and the screw part of the custom healing abutment at the point to the left in the Figure. However, at the point to the right in the Figure the contact between the custom healing abutment and the gingiva is almost half the height of the top part of the custom healing abutment. This is due to the angle of inclination of the implant in relation to the level of the gingiva.
[00303] Figure 3 shows schematic examples of an implant abutment, a custom healing abutment and a final restoration in an implant.
[00304] Figure 3a) shows an example of a custom healing abutment 301 in dotted lines on implant 304 similar to the custom healing abutment in Figures 2a) and 2b). Implant abutment 306 for a final restoration is also shown. Custom Healing Abutment 301 and Implant Abutment 306 are not configured to be arranged on implant 304 at the same time. The custom healing abutment is configured to lie on the implant while the implant connects to the mandibular bone through osseointegration. When healing is complete, ie the implant is firmly connected to the mandibular bone, the customized healing abutment is removed from the implant and the implant abutment can be placed on the implant instead.
[00305] Figure 3b) shows an example of a final restoration 307 for implant abutment 306 on implant 304, in which implant abutment 306 and final restoration 307 are configured to be disposed on implant 306 after healing with the Custom healing abutment 301. Custom healing abutment 301 is shown in dotted lines to indicate that it is not present simultaneously with implant abutment 306 and final restoration 307. It is understood that the dimensions of the custom healing abutment, the abutment of implant and final restoration may be different from those shown in these Figures, for example, the custom healing abutment may be larger or small or wider or narrower in relation to the implant abutment and the final restoration than is shown in the Figure. The custom healing abutment preferably shapes and/or maintains the gingiva shape for the insertion of the final restoration.
[00306] Figure 4 shows a schematic example of an implant with a final restoration in a patient's mandible.
[00307] Figure 4 shows an implant 404 in the mandibular bone 411 of a patient. A final restoration 407 is attached to the 404 implant via a 406 implant abutment. The 406 implant abutment can be customized as the 401 healing abutment. at the same time as the 406 implant abutment and the final restoration.
[00308] In the 411 mandibular bone near the 404 implant, the original teeth 412 and 413 are present. The original teeth 412 and 413 comprise a natural crown 409 and natural roots 410. The gingiva 405 is shown to be present on the edge between the roots 410 and the crown 409, however it is understood that the gingiva may be present anywhere below or higher on tooth 412, 413.
[00309] Figure 5 shows schematic examples of final restorations for an implant.
[00310] Figure 5a) shows an example of a final restoration 507 for a 504 implant, where the final restoration is arranged in a 515 coping on a standard 506 implant abutment. The coping can be customized. Final restoration 507 may be or may comprise a layer of veneer. The gum is indicated by the reference number 505.
[00311] Figure 5b) shows an example where the final restoration 507 is disposed on a standard implant abutment 506 secured to an implant 504 disposed in a drilled hole in the patient's mandibular bone. The emergence profile 5081 of the abutment 506 is the axial contour of the abutment 506 as it rises from the implant 506, i.e., from the implant towards the gingival air interface. Emergence profile 5082 of restoration 506 is the axial contour of the restoration where it arises from gingiva 505.
[00312] Figure 5c) shows an example where the final restoration is arranged in an implant abutment 506 retained by screw 516.
[00313] Figure 5d) shows an example where the final restoration 507 is arranged on a different type of implant abutment 506 retained by screw 516.
[00314] Figure 6 shows schematic examples of different relationships of the customized healing abutment in relation to the gingiva.
[00315] In Figure 6a) the custom healing abutment 601 is arranged in relation to the gingiva 605 in such a way that the custom healing abutment 601 cannot be seen, that is, the gingiva 605 only covers the custom healing abutment 601.
[00316] In Figure 6b) the custom healing abutment 601 is arranged in relation to the gingiva 605 in such a way that the custom healing abutment 601 is visible, that is, the gingiva 605 does not cover the upper surface of the custom healing abutment 601.
[00317] In Figure 6c) the custom healing abutment 601 is arranged in relation to the gingiva 605 in such a way that the custom healing abutment 601 is partially visible, i.e. the gingiva 605 covers a part, but does not cover the entirety of the upper surface of the custom healing abutment 601.
[00318] The percentage or amount or part of coverage of the upper surface of the customized healing abutment by the gingiva can be any value. That is, the gingiva can be, for example, 5 mm, 4 mm, 3 mm, 2 mm, 1 mm above or below the upper surface of the customized healing abutment. It is understood that the value does not need to be an integer of mm, but can be any integer or decimal number, for example, 1.8mm, 2.1mm, 3.4mm, 4.5mm, 5 .2 mm, etc.
[00319] Figure 7 shows an example of a flowchart of a method to virtually design the implant, restorations and guide drilling, etc. for a patient.
[00320] In step 701 a CT scan such as a CBCT and a 3D surface scan of the patient's tooth are obtained and the CT scan and 3D surface scan are aligned.
[00321] In step 702 all of the necessary restorations are virtually placed relative to the set of teeth in the aligned computed tomography and 3D surface scanning. The restorations can be restorations for an implant, such as a crown or bridge, but they can also be restorations for a prepared tooth, etc.
[00322] In step 703 the required or planned implants are loaded into the aligned CT and 3D surface scan.
[00323] In step 704 an iterative process is performed so that it comprises: virtually positioning the implants loaded in step 705, creating and designing abutments for the implants in step 706, where the abutments can be temporary abutments, such as custom healing abutments and/or final abutments such as implant abutments and, in the last step of the iterative process, creating or designing the final restorations and/or temporary restorations such as crowns and bridges are performed, step 707.
[00324] Finally, after the iterative process in step 704, a guide punch is virtually designed in step 708 and can be fabricated using direct digital fabrication equipment.
[00325] Figure 18 shows an example of a screen view of a computed tomography of a set of patient teeth.
[00326] Computed tomography can be seen from different directions, such as a top view of the tooth, a front view of the tooth and a side view of the tooth.
[00327] The screen view additionally shows scan information, graphics card information and options. Alternatively and/or additionally, views of additional directions and/or additional information may be shown.
[00328] Figure 9 shows an example of a CT scan and a 3D surface scan, which are aligned.
[00329] In Figure 9a), a computed tomography 916 of a set of patient teeth is shown. The 912 teeth are seen and the 910 teeth roots of the teeth are clearly seen on the CT scan.
[00330] In Figure 9b), a 3D surface scan 917 of the set of patient teeth is aligned relative to CT 916. The 3D surface scan provides information about soft tissue 905, such as the gingiva around teeth 912 , which may not be derived from computed tomography.
[00331] Figure 10 shows an example of a CT scan in which a nerve is indicated.
[00332] Figure 10 shows different views of computed tomography, as a 2D panoramic axial view in the upper left corner; a 2D panoramic view in the lower left corner; a 2D panoramic cross section at the bottom center; a 2D panoramic tangential view in the lower right corner; and the full 3D model in the upper right corner.
[00333] The 1017 nerve is indicated by means of lines or points in the different views. When the dentist or assistants look at this scan, the nerve is typically colored in such a way that it is easy to distinguish it from the rest of the features in the scan.
[00334] Figure 11 shows an example to virtually position a final restoration for an implant in relation to a set of teeth.
Restoration 1107 is in the form of a crown and is virtually placed in a position on the set of patient teeth where it replaces an original tooth. The set of teeth is represented here by means of a 3D surface scan obtained, for example, by means of an intraoral scan using, for example, the 3Shape TRIOS intraoral scanner.
[00336] Different 1118 tools such as control points and lines to virtually design the 1107 restoration are shown. By means of tools 1118 the virtual restoration 1107 can be made higher, lower, wider, narrower, thicker, or its shape can be modified, etc.
[00337] Figure 12 shows an example of a computed tomography in which an implant is virtually placed. Figure 12 shows different views of the CT scan, such as a 2D panoramic axial view in the upper left corner; a 2D panoramic view in the lower left corner; a 2D panoramic cross section at the bottom center; a 2D panoramic tangential view in the lower right corner; and the full 3D model in the upper right corner. Implant 1204 is indicated by solid lines or contours in different views. When the dentist or assistants look at this scan, the implant will typically be colored in such a way that it is easy to distinguish from the rest of the features in the scan. The views in Figure 12 can be presented to an operator, such as a dentist or dental technician, on a computer system monitor. The computer system also comprises a pointing tool, such as a computer mouse, that can be used to virtually position the implant in relation to the CT mandibular bone. The computer system often comprises software code stored on a computer-readable medium where the software code is configured to update the other views that can be seen in Figure 12 where the placement of the implant in one view is changed by the operator using, for example, a computer mouse.
[00338] Computed tomography can be a Cone Beam CT (CBCT) scan obtained using, for example, the I-CAT Cone Beam CT scanner or the Galileos scanner manufactured by Sirona
[00339] Figure 13 shows examples for virtually designing an abutment and a restoration for an implant.
[00340] In Figure 13a), a pillar is designed virtually. The abutment can be a custom 1301 healing abutment or a 1306 implant abutment for a final restoration.
[00341] In Figure 13b), a restoration is virtually designed. The restoration can be a temporary restoration for the implant during the healing period of the implant, or the restoration may be a final 1307 restoration for the implant.
[00342] Figure 14 shows an example of a guide hole fabricated to drill holes for implants in the patient's jaw. The guide hole has three ports to admit a means to protect the guide hole in relation to the patient's mandibular bone and four openings through which the surgical drill engages the mandibular bone.
[00343] Figure 15 shows an example of a custom healing abutment 1501 with scan markers 1519 for detecting the position and orientation of the implant 1504 on which the custom healing abutment is disposed.
[00344] Figure 16 shows a schematic drawing of a system to implement the embodiments of the present invention.
[00345] The system 1650 comprises a computer device 1651 comprising a computer readable medium 1652 and a processor 1653. The system further comprises a visual display unit 1656, a computer keyboard 1654 and a computer mouse 1655 for entering data , activate virtual buttons and move virtual control points displayed on the 1656 visual display unit. The 1656 visual display unit can be a computer screen. Computer device 1651 is capable of receiving a CT scan of the patient's set of teeth from a CT scan computer device 16571 or capable of receiving scanning data from such a scanning device and forming a CT scan of the set of teeth. based on such scan data. Computer device 1651 is also capable of receiving a 3D surface scan of the set of patient teeth from a surface scanning device 16572, such as the TRIOS intraoral scanner manufactured by 3shape A/S, or capable of receiving data. of such a scanning device and form a 3D surface scan of the patient's tooth set based on such scanning data. Computed tomography and 3D surface scanning received or formed can be stored on computer readable medium 1652 and provided to processor 1653. Processor 1653 is configured to align the computed tomography and 3D surface scanning to virtually position at least one implant in relation to computed tomography of the tooth; and to virtually design a customized healing abutment based on computed tomography using the method according to any of the modalities. In custom healing abutment design and virtual implant placement, one or more options can be presented to the operator. Options can be presented in a user interface viewed on the 1656 visual display unit.
[00346] The 1653 processor can also be configured to design a guide hole for surgically drilling a hole in the patient's mandibular bone to create space for the implant. The system then comprises a 1658 unit for transmitting a virtual 3D projected model of the guide drill to, for example, a 1659 computer-aided fabrication (CAM) device for manufacturing the guide drill or to another computer system, for example. , located in a remote manufacturing center, where the guide drill is manufactured. A virtual 3D model transmission unit can be a wired or wireless connection.
[00347] Figure 17 shows flowcharts of embodiments of the method of the invention.
[00348] Figure 17a shows a 1760 embodiment where the guide perforation and custom healing abutment are virtually designed based on CT and aligned 3D surface scans. Components are subsequently manufactured based on the designs using technical means of direct digital fabrication.
[00349] In step 1761 a CT scan comprising at least a portion of the patient's mandibular bone is obtained. When the patient has teeth in their mouth, CT scan can also understand the teeth and their roots. Computed tomography can be a Cone Beam Computed Tomography (CBCT) obtained using, for example, the I-CAT Cone Beam Computed Tomography scanner or the Galileos scanner manufactured by Sirona.
[00350] Optionally, a 3D surface scan comprising the teeth and soft tissue of the patient's mouth is also obtained in step 1762 using, for example, the TRIOS intraoral scanner manufactured by 3shape AS A TC obtained and surface scans 3D are then aligned at step 1763 using, for example, a computer-implemented interactive nearest-point algorithm. Combining the two scans provides a virtual representation of the patient's mouth with even more information than CT alone, such that, for example, soft tissue can be represented with greater resolution and accuracy in the combined representation. This is also illustrated in Figure 9.
[00351] In step 1764, the implant is placed virtually in relation to the mandibular bone in the computed tomography in such a way that it is arranged according to a planned implant placement. This can be done manually by the operator using a pointing tool such as a computer mouse, a computer system adapted to carry out the method, or it can be done automatically using computer-implemented algorithms configured to determine an appropriate orientation and location in relation to the mandibular bone. Implant positioning can be optimized in relation to the suitability of the mandibular bone to support the implant and in relation to the insertion directions for the implant in the hole that is to be drilled into the mandibular bone.
[00352] In 1765, the guide hole and custom healing abutment are designed, wherein the design of the guide hole and custom healing abutment is at least partially based on computed tomography and planned implant placement. A guide hole is designed to guide the surgical drilling of an implant hole in the patient's mandibular bone in planned implant placement, while the custom healing abutment is configured to conform soft tissue to a target profile when disposed in the implant.
[00353] When designed, the guide perforation and custom healing abutment can be fabricated using direct digital fabrication technical means such as 3D printing or lamination in step 1766. This step can be performed in a separate system or facility, as a specialized dental laboratory.
[00354] Figure 17b shows a 1767 modality in which the design comprises virtually positioning a final restoration for the implant before virtually positioning the implant in relation to computed tomography.
[00355] In step 1761, a CT scan comprising at least a portion of the patient's mandibular bone is obtained. When the patient has teeth in their mouth, CT scan can also understand the teeth and their roots. Computed tomography can be a Cone Beam Computed Tomography (CBCT) obtained using, for example, the I-CAT Cone Beam Computed Tomography scanner or the Galileos scanner manufactured by Sirona.
[00356] In step 1772, a final restoration for the implant is designed and placed virtually in relation to the computed tomography. The final restoration can be designed to achieve the best possible esthetic appearance when the fabricated restoration is subsequently attached to the implant in the patient's mouth.
[00357] In step 1764, the implant is placed virtually in relation to the mandibular bone in the computed tomography in such a way that it is arranged according to a planned implant placement. This can be done manually by the operator using a pointing tool such as a computer mouse, a computer system adapted to carry out the method, or it can be done automatically using computer-implemented algorithms configured to determine an appropriate orientation and location in relation to the mandibular bone. Implant positioning can be optimized in relation to the suitability of the mandibular bone to support the implant and in relation to the insertion directions for the implant in the hole that is to be drilled into the mandibular bone. With the final restoration already in place relative to CT, it can also be taken into account when virtually inserting the implant and determining the planned implant placement. An advantage of this is that the planned implant placement can be tailored to provide that the implant can support the final restoration in the mouth when the final restoration is shaped as designed in step 1772. The placement of the implant is thus optimized with respect to obtaining a final esthetic restoration and in relation to obtaining a good mechanical function of the implant in the mandibular bone.
[00358] In 1765 the guide hole and custom healing abutment are designed, wherein the design of the guide hole and custom healing abutment is at least partially based on computed tomography and planned implant placement. A guide hole is designed to guide the surgical drilling of an implant hole in the patient's mandibular bone in planned implant placement, while the custom healing abutment is configured to conform soft tissue to a target profile when disposed in the implant.
[00359] When designed, the guide perforation and the customized healing abutment can be fabricated using direct digital fabrication technical means such as 3D printing or lamination in step 1766. This step can be performed in a separate system or facility, as a specialized dental laboratory.
[00360] In some embodiments, steps 17a and 17b are combined in such a way that the custom healing abutment and guide perforation are virtually designed based on a combination of a 3D surface scan and a CT scan that comprises the patient's mandibular bone, where the final restoration has been placed virtually in relation to the CT scan prior to implantation.
[00361] Figure 19 shows a flowchart for the procedure for extracting a tooth and replacing it with an implant and a corresponding final restoration.
[00362] In 1971 a CT scan comprising at least a portion of the patient's mandibular bone is obtained. When the patient has teeth in their mouth, CT scan can also understand the teeth and their roots. Optionally, a 3D surface scan comprising at least a portion of the tooth and at least a portion of the soft tissue of the patient's mouth is also obtained.
[00363] In 1972, a guide drill is virtually designed to guide the surgical drilling of an implant hole in the patient's mandibular bone and a custom healing abutment is designed virtually to shape the soft tissue into the drilled hole. This can be done before a tooth is extracted. The project comprises virtually positioning the implant in relation to the CT tooth and ensures that the physical implant placed in a hole drilled using the guide hole is placed according to the virtual positioning of the implant and that the customized healing abutment can form the soft tissue according to a target profile when disposed in the implant. The target soft tissue profile can be determined from a desirable emergence profile of the final restoration for the implant. Based on the designs, the guide perforation and custom healing abutment can be fabricated using direct digital fabrication such as 3D printing or lamination.
[00364] In step 1973, the guide perforation and the customized healing abutment are manufactured based on the designs using, for example, a 3D printer or a laminating machine.
[00365] In step 1974, the hole is drilled in the patient's mandibular bone using the fabricated guide hole.
[00366] In step 1975, the implant is disposed in the hole and the customized healing abutment is disposed in the implant. In case a temporary restoration has been designed and fabricated, it is secured to the custom healing abutment.
[00367] The customized healing abutment remains in the implant while the implant heals into the mandibular bone through osseointegration. During healing, the soft tissue takes the shape dedicated by the surface of the customized healing abutment so that the soft tissue can be shaped to a target profile. The target profile is chosen such that the shaped soft tissue follows a desirable emergence of a final restoration/final pillar for the implant. In case the final restoration and final abutment have been designed and manufactured earlier in the process, they can then be placed in the patient's mouth once healing is complete, with the final abutment secured to the implant and the final restoration cemented on the final pillar. In 1976 the customized healing abutment is removed from the implant and a final abutment is placed on the implant. The final restoration is then cemented onto the final abutment.
[00368] With the present invention in which the guide perforation and customized healing abutment are designed to ensure that an implant disposed in a hole drilled in the patient's mandibular bone using the guide perforation is placed according to the positioning The implant's virtual implant and the custom healing abutment is designed to form the soft tissue to the target profile when laid out in the implant, steps 1972 to 1975 can potentially be performed during a single visit to the dentist. After discussing the situation with the patient based on the scans, the guide perforation and custom healing abutment are designed and manufactured while the dentist prepares the patient for perforation, ie administration of anesthetics and extraction of the original tooth. The guide hole is then used for surgical drilling and the customized healing abutment is placed on the implant which is placed in the drilled hole.
[00369] In fact, stage 1971 can also be performed during this one-time visit. However, often the dentist prefers to have obtained and evaluated the scans before the visit where the surgical perforation takes place.
[00370] The final restoration can be designed and fabricated in conjunction with the design and fabrication of the guide hole and custom healing abutment, such that the guide hole and custom healing abutment are designed based on the final restoration and in such a way that the project is completed at once. This approach assumes that the placement of the implant in the mandibular bone during osseointegration does not change. In some cases where the dentist decides that there is a high risk of the implant moving during implant healing in the mandibular bone, the dentist may choose to wait until healing is final and then obtain a second CT scan of the abutment of customized healing and surrounding teeth. From the second CT scan, the dentist can then design the final abutment and the final restoration taking into account the exact position and orientation of the implant in relation to the patient's tooth.
[00371] Figure 20 shows a custom healing abutment design where the transition to the implant screw is smooth. The Figures in this document are cross-sectional illustrations of the oral situation and the implant as viewed from a neighboring tooth.
[00372] Figure 20a shows the implant 2004 arranged in the patient's mandibular bone 2011 and the surrounding gingiva 2005. The custom healing abutment 2001 is arranged on the implant 2004 such that the holes 2092 of the two are aligned. The 2001 Custom Healing Abutment has a 2090 topmost surface that comprises a 2091 opening for the head of the implant screw.
[00373] Figure 20b shows an implant screw 2093 with a screw head 2094 and a screw body 2095. The screw head has a height Ahead and the screw body a height Abody along the longitudinal axis of the screw 2093 .
[00374] Figure 20c shows the situation where the 2001 custom healing abutment is secured to the 2004 implant using the implant screw that has a 2095 body that extends along the holes of the custom healing abutment and implant. The custom healing abutment is virtually designed to take into account the information regarding the implant screw such that the custom healing abutment is designed to provide a smooth 2096 transition between the 2090 uppermost surface of the healing abutment Custom Healing Abutment 2001 and the uppermost surface of the 2094 screw head. As seen in the Figure, the 2001 Custom Healing Abutment is designed such that the 2094 screw head completely covers the opening in the uppermost surface of the 2001 Custom Healing Abutment and the 2094 screw head completely cover the side wall of the opening when the fabricated custom healing abutment is connected to the implant in the 2011 patient jaw using the 2093 implant screw. Similarly, the 2094 screw head side wall cannot be seen when the 2096 transition is smooth. The smooth transition can be such that the uppermost surfaces of the custom healing abutment and implant screw head are in the same plane when the implant screw is disposed relative to the custom healing abutment. The custom healing abutment design can be such that it sets the opening height to a value identical to the screw head height. Head screw head such that the screw head does not extend above the uppermost surface of the customized healing abutment or vice versa.
[00375] Although some embodiments have been described and shown in detail, the invention is not restricted thereto, and may also be incorporated in other ways falling within the scope of matter defined in the following claims. In particular, it is to be understood that other embodiments can be used and structural and functional modifications can be made without departing from the scope of the present invention.
[00376] In device claims that enumerate multiple media, several such media may be incorporated by one and the same item of equipment. The mere fact that certain measures are referred to in mutually different dependent claims or described in different modalities does not indicate that a combination of these measures cannot be used to advantage.
[00377] A claim may refer to any one of the preceding claims, and "any" is understood to mean "any one or more" of the preceding claims.
[00378] It should be noted that the term "comprises/understands" when used in this descriptive report is taken to specify the presence of features, integers, steps or components mentioned, but does not exclude the presence or addition of one or more other features , integers, steps, components or groups thereof.
[00379] The method features described above and below can be implemented in a software and performed in a data processing system or other processing means caused by the execution of executable instructions by computer. Instructions can be a means of program code loaded into memory, such as RAM, from a storage medium, or from another computer over a computer network. Alternatively, the features described can be implemented through a programmed circuit rather than software or in combination with software. MODALITIES
[00380] 1. A method for virtually designing a customized healing abutment and guide perforation for a patient, wherein the method comprises:
[00381] - obtain a computed tomography that comprises at least a part of the patient's mandibular bone;
[00382] - virtually position at least one implant in relation to the mandibular bone in the computed tomography such that a planned implant placement is defined; and
[00383] - design virtually:
[00384] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in planned implant placement; and
[00385] • a custom healing abutment configured to conform the soft tissue to a target profile when disposed on the implant;
[00386] in which the design of the guide perforation and customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00387] 2. The method according to modality 1, wherein the method comprises obtaining a 3D surface scan comprising at least a portion of the tooth and at least a portion of the soft tissue of the patient's mouth.
[00388] 3. The method according to any one of one or more prior embodiments, wherein the method comprises performing a computed tomography alignment and 3D surface scanning prior to designing the custom healing abutment and guide perforation.
[00389] 4. The method according to any one of one or more prior modalities, wherein the alignment comprises selecting three corresponding points in computed tomography and 3D surface scanning.
[00390] 5. The method according to any one of one or more foregoing embodiments, wherein the alignment comprises using the computer-deployed method of nearest interactive points.
[00391] 6. The method according to any one of one or more prior modalities, wherein the guide perforation and the customized healing abutment are designed simultaneously.
[00392] 7. The method according to any one of one or more antecedent modalities, in which the computed tomography is a preoperative computed tomography obtained before surgical perforation in the patient's mandibular bone and/or in which the surface scan 3D is a preoperative 3D surface scan taken prior to surgically perforating the patient's mandibular bone.
[00393] 8. The method according to any one of one or more prior embodiments, wherein the method comprises virtually positioning a final restoration for the implant.
[00394] 9. The method according to any one of one or more prior modalities, wherein the final restoration is placed virtually before virtually positioning the implant.
[00395] 10. The method according to any one of one or more prior embodiments, wherein the method comprises virtually designing the final restoration, such as a crown, bridge, or denture.
[00396] 11. The method according to any one of one or more prior modalities, wherein the method comprises using the shape of the original tooth to design the final restoration.
[00397] 12. The method according to any one of one or more antecedent modalities, wherein the final restoration design is at least partially based on the custom healing abutment design.
[00398] 13. The method according to any one of one or more antecedent modalities, in which the final restoration comprises the subgingival portion and the subgingival portion is based on the custom healing abutment design.
[00399] 14. The method according to any one of one or more prior modalities, wherein the method comprises virtually designing a final implant abutment for insertion into the implant, wherein the final restoration is adapted to be coupled to the final abutment of implant.
[00400] 15. The method according to any one of one or more prior modalities, wherein the method comprises obtaining a second CT scan and/or a second 3D surface scan comprising the customized healing abutment when placed in the mouth of the patient and based on the second CT scan and/or the second 3D surface scan, adjust the design of the final restoration.
[00401] 16. The method according to any one of one or more prior embodiments, wherein the customized healing abutment is adapted to be disposed at least partially in soft tissue having a desirable position and orientation relative to the implant.
[00402] 17. The method according to any one of one or more antecedent modalities, wherein the custom healing abutment design is at least partially based on the design of the final restoration.
[00403] 18. The method according to any one of one or more antecedent modalities, in which the custom healing abutment design is at least partially based on a visible part of the neighboring tooth and/or a part not visible to the neighboring tooth.
[00404] 19. The method according to any one of one or more prior modalities, wherein the custom healing abutment design is at least partially based on the soft tissue at the location where the custom healing abutment is adapted to be disposed .
[00405] 20. The method according to any one of one or more prior modalities, wherein the custom healing abutment design is at least partially based on a desired soft tissue shape between the implant and the final restoration.
[00406] 21. The method according to any one of one or more antecedent modalities, wherein the method comprises virtually projecting the emergence profile of the customized healing abutment from the top of the implant to the beginning of the gingiva.
[00407] 22. The method according to any one of one or more prior modalities, wherein the method comprises using the shape of the original tooth to design the customized healing abutment.
[00408] 23. The method according to any one of one or more prior modalities, wherein the custom designed healing abutment comprises a substantially flat rounded top.
[00409] 24. The method according to any one of one or more prior modalities, wherein the customized healing abutment is designed to be flush with the surrounding soft tissue.
[00410] 25. The method according to any one of one or more prior modalities, wherein the customized healing abutment is designed to have a predetermined height in relation to the surrounding soft tissue.
[00411] 26. The method according to any one of one or more prior modalities, wherein the custom healing abutment design is not adapted for the fixation of a temporary crown or other temporary restoration.
[00412] 27. The method according to any one of one or more antecedent modalities, wherein the custom healing abutment design comprises scanning markers to derive implant position and orientation information when scanning the customized healing abutment in the implant.
[00413] 28. The method according to any one of one or more antecedent modalities, wherein the scan markers and their position on the custom healing abutment are virtually designed to match the custom healing abutment.
[00414] 29. The method according to any one of one or more prior embodiments, wherein the method comprises virtually designing the insertion of the implant into the patient's mouth.
[00415] 30. The method according to any one of one or more prior embodiments, wherein the method comprises using the shape of the original tooth to design the position and orientation of implant placement.
[00416] 31. The method according to any one of one or more antecedent modalities, in which the design of the virtual implant provides that the implant is adapted to be inserted into the patient's mandibular bone where the planned implant placement is such so that the implant is not placed in a tooth root of another tooth or in a nerve.
[00417] 32. The method according to any one of one or more prior embodiments, wherein the method comprises virtually performing a collision detection of the implant with respect to tooth roots or neighboring implants.
[00418] 33. The method according to any one of one or more prior embodiments, wherein the method comprises providing virtually limitations for the implant in relation to the visible part of the neighboring tooth.
[00419] 34. The method according to any one of one or more prior embodiments, wherein the method comprises virtually planning the surgical drilling of the hole for the implant.
[00420] 35. The method according to any one of one or more antecedent modalities, in which the virtual planning of surgical perforation is designed based on computed tomography.
[00421] 36. The method according to any one of one or more prior modalities, in which the virtual planning of the surgical drilling and/or virtual design of the guide drilling is/are designed based on the 3D surface scanning .
[00422] 37. The method according to any one of one or more prior embodiments, wherein the method comprises extracting virtually any teeth that are placed where an implant is intended to be disposed.
[00423] 38. The method according to any one of one or more prior modalities, wherein the method comprises virtually projecting the soft tissue surrounding the customized healing abutment.
[00424] 39. The method according to any one of one or more prior modalities, wherein the method comprises virtually projecting the soft tissue surrounding the customized healing abutment using the original soft tissue format of the CT and/ or 3D surface scanning.
[00425] 40. The method according to any one of one or more prior modalities, wherein the custom healing abutment design is configured for attaching a temporary restoration to the custom healing abutment.
[00426] 41. The method according to any one of one or more prior embodiments, wherein the custom healing abutment design comprises means for attaching a temporary restoration such as a temporary crown or a temporary bridge.
[00427] 42. The method according to any one of one or more prior embodiments, wherein the customized healing abutment comprises a screw hole for retaining the temporary restoration such as the temporary crown.
[00428] 43. The method according to any one of one or more prior modalities, wherein the temporary restoration, such as a temporary crown, is adapted to be cemented to the custom healing abutment.
[00429] 44. The method according to any one of one or more prior modalities, wherein the method comprises virtually designing a temporary restoration for attachment to the customized healing abutment.
[00430] 45. The method according to any one of one or more prior modalities, wherein the computed tomography is a cone beam computed tomography (CBCT).
[00431] 46. The method according to any one of one or more prior modalities, wherein the 3D surface scan is an intraoral scan captured directly in the patient's mouth and/or a scan of a physical impression of the tooth/gums of the patient and/or a scan of a physical model of the patient's tooth/gums.
[00432] 47. The method according to any one of one or more prior embodiments, wherein the method comprises virtually designing a radiographic mold adapted for positioning in the patient's tooth to simulate an implant position and/or a final restoration.
[00433] 48. The method according to any one of one or more prior embodiments, wherein the method comprises obtaining a CT scan and/or a 3D surface scan of a radiographic mold disposed on the patient's tooth.
[00434] 49. The method according to any one of one or more antecedent modalities, in which virtually positioning the implant and virtually designing the customized healing abutment are performed as a part of an iterative process in which each iteration of the iterative process comprises evaluate implant placement and/or custom healing abutment design and based on an assessment result that determines whether implant placement and/or custom healing abutment design should be modified.
[00435] 50. The method according to any one of one or more antecedent modalities, in which the evaluation of the iterative process takes into account the design of the final restoration.
[00436] 51. The method according to any one of one or more antecedent modalities, where virtually designing the final restoration is a part of the iterative process and where the assessment determines whether the design of the final restoration should be modified.
[00437] 52. The method according to any one of one or more antecedent modalities in which the placement of the implant is modified based on the custom designed healing abutment and/or based on the designed final restoration.
[00438] 53. The method according to any one of one or more antecedent modalities in which the customized healing abutment is redesigned based on modified implant placement and/or based on the engineered final restoration.
[00439] 54. The method according to any one of one or more antecedent modalities, wherein the iterative process comprises redesigning the final restoration based on modified implant placement and/or redesigned custom healing abutment.
[00440] 55. The method according to any one of one or more prior modalities, wherein the guide perforation is designed virtually based on the planned implant placement after iteration of the iterative process.
[00441] 56. A user interface for virtually designing a custom healing abutment and guide perforation for a patient, where the user interface is configured to:
[00442] - obtain and view a computed tomography that comprises at least part of the patient's mandibular bone;
[00443] - virtually position at least one implant in relation to the computed tomography mandibular bone in such a way that a planned implant placement is defined; and
[00444] - design virtually:
[00445] • a guide drill to guide the surgical drilling of an implant hole in the patient's mandibular bone in planned implant placement; and
[00446] • a custom healing abutment configured to conform soft tissue to a target profile when disposed on the implant
[00447] in which the design of the guide perforation and the customized healing abutment is at least partially based on computed tomography and planned implant placement.
[00448] 57. The user interface according to embodiment 56, wherein the user interface is configured to obtain and view a 3D surface scan comprising at least a portion of the tooth and soft tissue of the patient's mouth.
[00449] 58. The user interface according to modality 56 or 57, wherein the user interface is configured to perform a CT alignment and 3D surface scan before designing the custom healing abutment and perforation -guide.
[00450] 59. The user interface according to any one of embodiments 56 to 58, wherein the user interface is configured to virtually position a final restoration for an implant with respect to computed tomography and/or with respect to scanning of 3D surface and to virtually design the final restoration.
[00451] 60. The user interface according to any one of embodiments 56 to 59, wherein the user interface is configured to virtually position the final restoration prior to virtually positioning the implant.
[00452] 61. The user interface according to any one of modalities 56 to 60, wherein the user interface is configured to be viewed by an operator with a computer screen and to allow the operator to input data and perform choices presented in the user interface via a computer keyboard or a computer mouse.
[00453] 62. The user interface according to any one of modalities 56 to 61, wherein the user interface is configured for viewing the implant along with computed tomography and optionally 3D surface scanning and the interface The user interface comprises a virtual tool to perform custom healing abutment design and guide perforation when activated.
[00454] 63. A method for virtually designing a customized healing abutment for a patient, wherein the method comprises:
[00455] - obtain a computed tomography that comprises at least a part of the patient's mandibular bone;
[00456] - obtain information regarding an implant screw by which the customized healing abutment must be coupled to an implant, wherein the implant screw comprises a screw head; and
[00457] - virtually design a custom healing abutment taking into account the implant screw information, where a more upper surface of the custom healing abutment is designed to comprise an opening to accommodate the screw head and where the custom healing abutment is designed to provide a smooth transition from custom healing abutment to implant screw.
[00458] 64. The method according to any one of one or more antecedent modalities, in which the information is related to the height of the screw head of the implant and in which the opening of the customized healing abutment is shaped to provide that transition from the customized healing abutment to the implant screw is smooth.
[00459] 65. The method according to any one of one or more antecedent modalities, in which the information is related to the length of the implant screw and in which the customized healing abutment is designed to have a length that provides the transition from the customized healing abutment to the implant screw is smooth.
[00460] 66. The method according to any one of one or more prior embodiments, wherein the customized healing abutment is designed to have a height falling within a range defined by the screw length.
[00461] 67. The method according to any one of one or more prior modalities, wherein the customized healing abutment is virtually designed in such a way that it is configured to conform soft tissue according to a target profile when disposed in the implant.
[00462] 68. The method according to any one of one or more prior embodiments, wherein the method comprises virtually positioning at least one implant relative to the mandibular bone on the CT scan such that a planned implant placement is defined.

权利要求:
Claims (10)
[0001]
1. Method for virtually designing a customized healing abutment (201) and a guide perforation for a patient, characterized in that it comprises: - obtaining (101a) a computed tomography that comprises at least part of the patient's mandibular bone; - virtually positioning (102a) at least one implant (204) relative to the mandibular bone on the CT scan such that a planned implant (204) positioning is defined; and - virtually designing (103a): - a guide hole to guide the surgical drilling of an implant hole (204) in the patient's mandibular bone in the intended implant placement (204); and - a custom healing abutment (201) configured to conform the soft tissue to a target profile when disposed on the implant (204), wherein the opening of the custom healing abutment (201) is shaped to provide a smooth transition from the custom healing abutment (201) to the implant screw (204); where the design of the guide perforation and customized healing abutment (201) is at least partially based on the CT scan and planned implant placement (204).
[0002]
2. Method according to claim 1, characterized in that the method comprises obtaining (101b) a 3D surface scan comprising at least part of the tooth and at least part of the soft tissue of the patient's mouth and performing an alignment CT scan and 3D surface scanning before designing the custom healing abutment (201) and the guide perforation.
[0003]
3. Method according to claim 1, characterized in that it comprises the step of virtually positioning (102b) a final restoration for the implant (204).
[0004]
4. Method according to claim 1, characterized in that the final restoration design is at least partially based on the design of the customized healing abutment (201).
[0005]
5. Method according to claim 1, characterized in that the final restoration comprises a subgingival portion, and the subgingival portion is based on the customized healing abutment design (201).
[0006]
6. Method according to claim 1, characterized in that the customized healing abutment (201) is adapted to be disposed at least partially in soft tissue that has a desired position and orientation with respect to the implant (204) .
[0007]
7. Method according to claim 1, characterized in that the design of the customized healing abutment (201) is at least partially based on the design of the final restoration.
[0008]
8. Method according to claim 1, characterized in that the method comprises virtually projecting (103b) the emergence profile of the customized healing abutment (201) from the top of the implant (204) to the beginning of the gum.
[0009]
9. Method according to claim 1, characterized in that the method comprises the use of the original tooth shape to design the customized healing abutment (201).
[0010]
10. Kit comprising a customized healing abutment (201) and a guide hole for a patient, characterized in that it comprises: • a guide hole to guide the surgical drilling of an implant hole (204) in the mandibular bone of the patient in the planned implant placement (204); and • a custom healing abutment (201) configured to conform soft tissue to a target profile when disposed on the implant (204), wherein the opening of the custom healing abutment (201) is shaped to provide a smooth transition from the custom healing abutment (201) to the implant screw (204); where the guide hole and custom healing abutment (201) are configured to cause an implant (204) disposed in a hole drilled using the guide hole to be positioned in the implant placement (204) so planned that the customized healing abutment (201) can conform the soft tissue according to the target profile when disposed in the implant (204).

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法律状态:
2018-12-04| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2020-04-14| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-05-04| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-06-01| B350| Update of information on the portal [chapter 15.35 patent gazette]|

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2021-06-22| 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 19/12/2012, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US201161578603P| true| 2011-12-21|2011-12-21|

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DKPA201100989|2011-12-21|

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US61/578,603|2011-12-21|

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DKPA201100989|2011-12-21|

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PCT/EP2012/076204|WO2013092744A1|2011-12-21|2012-12-19|Virtually designing a customized healing abutment|

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