CN105497981A - Three-dimensional-printing-technology-based alveolar bone restoration method - Google Patents

Abstract

The present invention discloses a three-dimensional-printing-technology-based alveolar bone restoration method. A defective alveolar bone is analyzed positioned preoperatively according medical image data of a patient with moderate-severe alveolar bone defects caused by chronic periodontitis for determination of shape and size of the defective alveolar bone for establishment of a three-dimensional model, a biodegradable osteanagenesis-induction biocompatible material is selected, and the defective alveolar bone model is printed for molding by a three-dimensional biological printing technology. By accurate measuring of size and volume of an alveolar bone restoration module, bone meal addition amount calculation errors caused by human factors can be reduced; due to changes in bone meal particle formation traits, a bone defect repair form produced by an implant not only can effectively fill the defects in the bone, but also can stably improve a vertical osteanagenesis promotion material piling height, repairs part of horizontal alveolar bone absorption, and improves alveolar bone regeneration capacity; by use of rapid forming technology, alveolar bone restoration modules required for different patients can be formed, the internal porosity rate is adjustable, and the forming efficiency is high.

Description

A kind of alveolar repair method based on three-dimensional printing technology

Technical field

The present invention relates to therapeutic treatment field and Dental implantion field, particularly a kind of alveolar repair method based on three-dimensional printing technology.

Background technology

Periodontal disease is one of large class principal disease of Human Oral Cavity two, and at China's sickness rate up to 80 ﹪, being the main cause causing adult's loss of tooth, is also the principal disease of harm humans tooth and whole body health.Desirable periodontal disease therapeutic, not only be to remove paathogenic factor, diminish inflammation to control disease progression, and the periodontal tissue by pathological changes is destroyed will be made to recover original structure and function, namely realize the regeneration of periodontal tissue's (gingiva, alveolar bone, periodontal membrane and cementum).Traditional periodontal disease therapeutic method is mainly through scaling, and mechanically to remove the speckle in periodontal capsule, but traditional periodontal treatment method can not make the periodontal tissue of forfeiture obtain regeneration.At present, guided tissue regeneration (Guidedtissueregeneration, GTR), periodontal bone grafting operation, periodontal regenerative art in conjunction with various somatomedin obtains the topmost operation method of paradenlal tissue regeneration, but discovered in recent years only plays mechanical barrier function due to GTR, lack enough competent cells, differentiation-inducing and acceleration of growth effect is initiatively lacked to regenerating tissues composition, and the periodontal membrane of remnants and more weak with osseous tissue repair ability inherently, affect paradenlal tissue regeneration, the maintenance ability of collagem membrane to space is poor in addition, also paradenlal tissue regeneration is unfavorable for, these all cause the amount of paradenlal tissue regeneration and speed comparatively limited, for chronic periodontitis, long-term chronic inflammatory disease makes host self mescenchymal stem cell quantity reduce, function is impaired, be difficult to the requirement meeting osteanagenesis operation.

The stability of oral cavity inner teeth gear mainly relies on periodontal tissue, especially the support of alveolar bone.When suffering from periodontal disease, same teeth is at different parts and facing, and there is frontal resorption multi-form and in various degree and destroy, profile is different.The operation of tradition alveolar repair is that bone meal is directly implanted in Alveolar Bone Defect region after gingiva turns over lobe, then covers upper periosteum, but due to frontal resorption failure mode different, there is implantation bone meal operating time long, not easily pile up, complicated operation, easily cause the shortcomings such as infection.And the new technique that 3D printing technique is combined with medical science, biomaterial, computer technology, can for the specific anatomical structure of patient, physiological function and Treatment need, under three-dimensional digital model drives, orientation assemble biomaterial, manufacture a can personalized customization, the absorbable alveolar bone implantation body of material.

Three-dimensional printing technology is a kind of is the technology that the method adopting material to add up gradually manufactures entity.Relative to traditional material removal technique, three-dimensional printing technology has the model that manufactures a product, sample time is short, without the need to assembling, and the features such as accurate physical replication and personalized production, at present widely apply by every field, the impact for medical field is revolutionary especially.Because everyone body make-up and pathological condition all exist particularity and differentiation, after biomedical information combine with technique, 3D printing technique demonstrates its unique advantage in the individual character manufacturing of human organ manufacture, surgical simulation, artificial implant and medical apparatus and instruments.The present invention proposes a kind of personalization based on 3D printing technique, the absorbable alveolar repair method of material.

This method is assessed Alveolar Bone Defect patient according to the medical image data of patient, excavation can carry out I wall, II wall, the III wall bone bag of periodontal guide regeneration art, derive three-dimensional data, carry out the three-dimensional reconstruction of Level of Alveolar Bone defect module, biological three-dimensional printing technology is utilized to prepare satisfactory personalized alveolar repair module according to model, solve material stacking insufficient height in traditional operation, the problems such as the time length of operation, decrease operating difficulty, medical science, materialogy and manufacturing technology are organically combined, reaches the object of translational medicine.

Summary of the invention

The object of the invention is to exist for existing alveolar repair method that to implant bone meal operating time long, complicated operation, the shortcoming such as easily cause that infection, bone meal are not easily piled up, propose a kind of personalized alveolar bone based on biological three-dimensional printing technology and prepare restorative procedure.The medical image data that the method causes middle severe Alveolar Bone Defect patient according to chronic periodontitis in the preoperative carries out analyzing and positioning to defect alveolar bone, determine the shape of defect alveolar bone, size, set up threedimensional model, select degradable, can the biocompatible materials of bone induction and regeneration, utilize biological three-dimensional printing technology by defect alveolar bone model printing shaping.

For achieving the above object, the technical solution used in the present invention is specific as follows:

A kind of manufacture method of " personalization " alveolar bone, comprises the following steps:

Step (1), first from the periodontal training audit report of patient, obtain that the degree of depth (PD) is examined in spy, attachment loss (CAL), Movable degree, bleeding index (BI), furcation area level probe into the periodontal index such as the degree of depth (HPD), then check the denture image data needed for obtaining according to the full mouth CBCT of this patient;

Described denture image data comprises the data of three angles of transverse section, sagittal plain, Coronal;

Step (2), the data obtained according to step (1), by the 3-D view of 3D image reconstruction algorithm or this patient teeth of Medical Image Processing software rebuild, obtain the three-dimensional configuration data of this patient teeth after quantitative measurement, set up tooth model;

In step (3), the tooth three-dimensional image that obtains in step (2), image segmentation algorithm is utilized to isolate the 3-dimensional image data of Alveolar Bone Defect module according to alveolar bone feature of image; Based on the shape of image resolution and imaging thickness determination Alveolar Bone Defect, size and position, the Alveolar Bone Defect that personalized designs and defect three-dimensional profile match repairs module;

Step (4), be the machine instruction file that three-dimensional printer can identify according to the reparation module converter in step (3), size, print speed, printing thickness, profile related printing parameters that Alveolar Bone Defect repairs module are set;

The size of described Alveolar Bone Defect reparation module, profile relevant parameter refer to that the Alveolar Bone Defect printed is repaired module and itself and Alveolar Bone Defect module are matched;

Described print speed is 0.5 ~ 9mm/s, printing thickness is 0.1 ~ 0.2mm;

Step (5), will select print biomaterial be drawn in micro-syringe, be assembled on three-dimensional printer, print platform places substrate, according to the print parameters that the biomaterial setting steps (4) selected is optimized, biological three-dimensional printer directly or indirectly prints alveolar repair module;

Described " personalization " alveolar bone method of direct printing: the internal structure design such as porosity, pore size, internal connectivity are carried out to the alveolar repair module in step (3), to meet osteoblastic absorption, extension, breeding, and threedimensional model is carried out layered shaping, generate corresponding printing path file.Biological three-dimensional printer controls the three-axis moving of shower nozzle under the guidance of printing path, successively prints to prepare wholely coincide with patient defective region and have the alveolar repair module of certain three-dimensional internal pore structure;

Described alveolar repair Module Pores rate is 40 ~ 80 ﹪;

Described pore size is 50 ~ 500 μm, in order to meet osteoblastic absorption, extension;

The described indirect Method of printing of " personalization " alveolar bone: shell is taken out to the alveolar repair module in step (3), and carry out layered shaping by taking out the threedimensional model after shell, generate corresponding printing path file, biocompatible material is used to print Alveolar Bone Defect mould, to insert degradable, there is pore structure, can promote the natural bone powder of osteanagenesis, be separated with mould after adding the platelet rich plasma albumen molding of autologous extraction.

Beneficial effect of the present invention:

1, build tooth model, fully represent clinical frontal resorption form, preoperative Alveolar Bone Defect is evaluated;

2, by accurately measuring size, the volume of alveolar repair module, anthropic factor is reduced on the impact of the erroneous calculations of bone meal addition;

3, alveolar bone material is that the natural material that degradable urgees bone does not need to be removed by second operation, reduces sufferer superinfection;

4, the change of bone meal grain forming character, the bone defect healing form that implant is made, not only effectively can clog intrabony defects, firmly can also increase Vertical dimension promoting bone regeneration material stacking height, repair part of horizontal type frontal resorption, promote Regeneration of Alveolar Bone amount;

5, utilize rapid shaping technique, produce rapidly, alveolar repair module needed for plastic different patient, interior porosity is adjustable, and shaping efficiency is high.

Accompanying drawing explanation

Fig. 1 is acquisition image data schematic diagram of the present invention; Wherein 1 ~ 3 is DICOM medical image;

Fig. 2 and Fig. 3 is the three-dimensional modeling schematic diagram of alveolar repair module of the present invention; Wherein 4 and 7 is tooth block mold, and 5 and 8 is defect alveolar bone tooth module, and 6 and 9 is alveolar repair module;

Fig. 4 is the schematic diagram of alveolar bone rapid shaping of the present invention; Wherein 10 is three-dimensional printer, and 11 and 13 tooth models being respectively alveolus bone lacks after embodiment 1,2 molding, 12 for adding the tooth model after the molding of alveolar repair module.

Detailed description of the invention

Below in conjunction with drawings and Examples, the present invention is further described.

Embodiment 1

By checking 42 years old capable periodontal training of patients with periodontal disease, the degree of depth (PD) is examined in the spy of record Alveolar Bone Defect tooth, attachment loss (CAL), Movable degree, bleeding index (BI), furcation area level probe into the periodontal index such as the degree of depth (HPD), and carry out full mouth CBCT inspection (1-3), as shown in Figure 1, find that patient is three-walled infrabony pocket periodontal bone defects, periodontal tissue's guide regeneration operation can be carried out.

As shown in Figure 2, based on the medical image data of CBCT gained, by image processing algorithm or Medical Image Processing software, as Mimics, rebuild the 3-D view (4) of tooth, split and rebuild the three-dimensional module (5) of teething groove bone Cranial defect tooth, based on the shape of image resolution and imaging thickness determination Alveolar Bone Defect, size and position, the Alveolar Bone Defect that personalized designs and defect three-dimensional profile match repairs module (6), and carry out periodental non-surgical treatment, the upper and lower scaling of gingiva, scrape and control, root planing, adjustment occlusion, desensitization process waits Preoperative Method.

As shown in Figure 4, internal structure design is carried out to alveolar repair module, and threedimensional model is carried out layered shaping, generate corresponding printing path file, be input to (10) in three-dimensional printer, bone meal is injected into micro-syringe, be assembled on printer, print speed is set to 3mm/s, prints pressure and be arranged to 0.55MPa, print thickness and be arranged to 0.16mm.

Print platform puts into substrate, printing head carries out scanning by the path in hierarchical file in X/Y plane and sprays bone meal material, utilize superlaser by the biomaterial of the deposition on the scanning pattern scanning substrate generated simultaneously, make biomaterial sinter molding on substrate.When one deck moulding prints complete, printing head raises 200 μm along the Z-direction of print platform, continue to spray bone meal material along specific direction on work top, on the material that superlaser prints before the thawing of this layer material being sticked to simultaneously, pile up layer by layer, until whole print module reaches the height of design, form pore diameter circle in the three-dimensional porous reparation module of 200 μm ~ 500 μm, be separated with substrate, printed alveolar repair module is implanted in patient's mouth, add the platelet rich plasma albumen of autologous extraction, and cover wound with inductive bone regeneration film.As shown in Figure 4,12 is the tooth model after enforcement 1 adds the molding of alveolar repair module, and 11 is the tooth model of alveolus bone lacks after enforcement 1 molding.

Embodiment 2

By checking 44 years old capable periodontal training of patients with periodontal disease, the degree of depth (PD) is examined in record spy, attachment loss (CAL), Movable degree, bleeding index (BI), furcation area level probe into the periodontal index such as the degree of depth (HPD), and carry out full mouth CBCT and check, find that patient is bag periodontal bone defects under two wall bones, periodontal tissue's guide regeneration operation can be carried out.

As shown in Figure 3, based on the medical image data of CBCT gained, utilize image processing algorithm or Medical Image Processing software, as Mimics, rebuild the 3-D view (7) of tooth, split and rebuild the three-dimensional module (8) of teething groove Cranial defect tooth, based on the shape of image resolution and imaging thickness determination Alveolar Bone Defect, size and position, the Alveolar Bone Defect that personalized designs and defect three-dimensional profile match repairs module (9), and carry out periodental non-surgical treatment, the upper and lower scaling of gingiva, scrape and control, root planing, adjustment occlusion, desensitization process waits Preoperative Method.

As shown in Figure 4, shell process is taken out to alveolar repair module, and carry out layered shaping by taking out the threedimensional model after shell, generate corresponding printing path file, be input to (10) in three-dimensional printer, biocompatible materials is injected into micro-syringe, be assembled on printer, print speed is set to 7mm/s, prints pressure and be arranged to 0.55MPa, print thickness and be arranged to 0.1mm.

Print platform puts into substrate, printing head carries out scanning by the path in hierarchical file in X/Y plane and sprays biomaterial, and be attached in respective path with substrate contacts, when one deck moulding prints complete, printing head raises 200 μm along the Z-direction of print platform, continue to spray biomaterial along specific direction on work top, pile up layer by layer, until whole print module reaches the height of design, form the repairing mould of alveolar bone, and be separated with substrate, the bone meal itself with certain hole is filled in printed alveolar repair mould, add the platelet rich plasma albumen of autologous extraction, make the mould that between bone meal, the rear removing of bonding is printed mutually, the bonding bone meal block of personalization is implanted in patient's mouth, and cover wound with inductive bone regeneration film.As shown in Figure 4,13 is the tooth model of alveolus bone lacks after enforcement 1 molding.

Above-described embodiment is not for restriction of the present invention, and the present invention is not limited only to above-mentioned case study on implementation, as long as meet application claims, all belongs to protection scope of the present invention.

Claims (8)

1., based on an alveolar repair method for three-dimensional printing technology, it is characterized in that the method comprises the following steps:

From the periodontal training audit report of patient, obtain that the degree of depth is examined in spy, attachment loss, Movable degree, bleeding index, furcation area level probe into the periodontal index such as the degree of depth, then check the denture image data needed for obtaining according to the full mouth CBCT of this patient;

According to the data of above-mentioned acquisition, by the 3-D view of 3D image reconstruction algorithm or this patient teeth of Medical Image Processing software rebuild, obtain the three-dimensional configuration data of this patient teeth after quantitative measurement, set up tooth model;

In above-mentioned tooth three-dimensional image, image segmentation algorithm is utilized to isolate the 3-dimensional image data of Alveolar Bone Defect module according to alveolar bone feature of image; Based on the shape of image resolution and imaging thickness determination Alveolar Bone Defect, size and position, the Alveolar Bone Defect that personalized designs obtains matching with defect three-dimensional profile repairs module;

According to reparation module converter be the discernible machine instruction file of three-dimensional printer, Alveolar Bone Defect is set and repairs the suitable related printing parameters such as size dimension, profile, print speed, printing thickness of module, the reparation module that prints and Alveolar Bone Defect template are matched;

By the degradable selecting to print, can the biocompatible material of bone induction and regeneration be drawn in micro-syringe, be assembled on three-dimensional printer, print platform places substrate, arrange the print parameters of above-mentioned optimization according to the biomaterial selected, biological three-dimensional printer directly or indirectly prints alveolar repair module.

2. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 1, the denture image data that it is characterized in that described in step (1) comprises the data of three angles of transverse section, sagittal plain, Coronal.

3. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 1, is characterized in that the print speed described in step (4) is 0.5 ~ 9mm/s.

4. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 1, is characterized in that the printing thickness described in step (4) is 0.1 ~ 0.2mm.

5. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 1, it is characterized in that described " personalization " alveolar bone method of direct printing is as follows: the internal structure design such as porosity, pore size, internal connectivity are carried out to the alveolar repair module in step (3), to meet osteoblastic absorption, extension, breeding, and threedimensional model is carried out layered shaping, generate corresponding printing path file; Biological three-dimensional printer controls the three-axis moving of shower nozzle under the guidance of printing path, successively prints to prepare wholely coincide with patient defective region and have the alveolar repair module of certain three-dimensional internal pore structure.

6. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 1, it is characterized in that the described indirect Method of printing of " personalization " alveolar bone: shell is taken out to the alveolar repair module in step (3), and carry out layered shaping by taking out the threedimensional model after shell, generate corresponding printing path file, biocompatible material is used to print Alveolar Bone Defect mould, to insert degradable, there is pore structure, can promote the natural bone powder of osteanagenesis, be separated with mould after adding the platelet rich plasma albumen molding of autologous extraction.

7. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 5, is characterized in that described alveolar repair Module Pores rate is 40 ~ 80 ﹪.

8. a kind of alveolar repair method based on three-dimensional printing technology as claimed in claim 5, is characterized in that described pore size is 50 ~ 500 μm, in order to meet osteoblastic absorption, extension.