Summary of the invention
In order to overcome above-mentioned the deficiencies in the prior art, the object of this invention is to provide a kind of segmentation delivery is gathered complete dental arch model method by the combination of computer registration, can gather except complete limitation of mouth opening (teeth clenched) and part severe limitation of mouth opening, other limitations of mouth opening patient's denture, can be successive treatment, as operation provides authentic data.
To achieve these goals, the technical solution used in the present invention is:
Segmentation delivery is gathered a method for complete dental arch model by the combination of computer registration, comprise the following steps:
1) choosing of tooth position: according to patient's limitation of mouth opening situation, determine whether upper and lower jaw needs segmentation delivery and need point several sections of deliverys, the upper jaw can use the dish delivery that puts one's child in a boarding nursery, lower jaw is because there being stopping of tongue, need point two sections of tooth positions or three sections of tooth position deliverys, when segmentation delivery, the complete tooth position that at least needs to overlap between adjacent two segment models, for later stage computer coupling;
2) making of tooth mould: the method that adopts secondary delivery, use interim wax segmentation pallet, after alginate impression material delivery, part charge is held together, and gypsum entirety is filled with mould, and gypsum blank mould completes, on blank mould plaster cast, make optical plastic substrate segmentation pallet, silicone rubber impression material secondary die, mould is filled with in gypsum segmentation, and segmentation denture gypsum completes;
4) by model spatial digitizer, every section of segmentation denture plaster cast is scanned, obtain initial data, save as respectively stl file;
5) adopt reverse engineering software-GeomagicQualify, carry out computer coupling segmentation denture, setting unit is millimeter;
6) software initial parameter is set, the stl file of selecting step 4, in software, form three-dimensional modeling view, then segmentation denture plaster cast 3-D view is mated to segmented model successively, if two sections of denture plaster cast 3-D views, adopt the method for " manual registration ", select " registration of n point ", a selected model is " fixing ", another model is elected " floating " as, on " fixing " model, be taken to the point of few 3 dispersions, comprise containing cheek, lingual surface and incisxal edge/cusp/jaw face, in " floating " model same position, mark same point, by " Register ", two segment models being realized substantially on locus overlaps, to ensure the coincidence of model on three-dimensional, carry out again " overall situation registration " and carry out meticulous coupling, check after average distance and standard deviation, two sections have the independent model registration of overlapping tooth position as a whole the most at last, if three sections of denture plaster cast 3-D views, adopt identical two sections of adjacent denture plaster casts of method coupling, mate with the 3rd section again, overlapping part between cutting remove model, obtain a complete dental arch model,
7) checking accuracy, taking the complete plaster cast of standard mandibular dentition as contrast groups, again the complete mandibular dentition model of three sections of registrations and the complete mandibular dentition plaster cast of standard are carried out after " registration " program of step 5, carry out " 3D comparison ", generate by " cloud atlas ", in cloud atlas, analyze its coincidence factor, thereby judge registration model whether with mouth in denture matching degree.
Two sections of described tooth positions are 37～42/41,47～32/31, three sections of tooth positions 37～33/44,34/35～44/45,43/44～47.
In described tailoring process, use " choosing thoroughly " function, at model lap, select non-anatomic landmark place as line of cut, delete the part overlapping between model, the optional two tooth adjoiners in non-anatomic landmark place.
After three described segment model registrations, overlapping part needs to delete, use " perspective " to observe the overlapping part of three segment models, avoid the important regions of anatomy such as cusp, use " straight line selection tool ", scale-up model, ensure that the shared picture of straight line is the narrowest, delete after this straight line, 1,3 two model has been divided into respectively two sections, delete its total part, complete the object that forms single " figure layer ", with 2,3 two models of method operation, finally formed a model that there is no lap.
The invention has the beneficial effects as follows:
1) obtain the method for complete dental arch model with respect to the personalized pallet of the making complexity relating in existing research, the present invention relies on computer software registration, can save the time of making individual tray, be convenient to clinical delivery, even if there is indivedual teeth position disappearance, there is overlapping region as long as meet between every segment model, also can carry out registration.
2) by the denture after computer software registration, can be used for mating with jawbone, carry out surgical simulation, for instructing operating carrying out. The patient who particularly needs Repeated Operation for limitation of mouth opening companion dentomatillofacial detormity, the method can be the in the situation that of patient's conditions permit, reduces operation number of times, thereby reduces patient's operation wound.
Detailed description of the invention
Below in conjunction with concrete enforcement, the present invention is further narrated.
As shown in Figure 1, a kind of segmentation delivery is gathered the method for complete dental arch model by the combination of computer registration, comprise the following steps:
1) choosing of tooth position: according to patient's limitation of mouth opening situation, determine whether upper and lower jaw needs segmentation delivery and need point several sections of deliverys, the upper jaw can use the dish delivery that puts one's child in a boarding nursery, lower jaw is because there being stopping of tongue, need point two sections of tooth positions or three sections of tooth position deliverys, when segmentation delivery, the complete tooth position that at least needs to overlap between adjacent two segment models, for later stage computer coupling;
2) making of tooth mould: the method that adopts secondary delivery, use interim wax segmentation pallet, after alginate impression material delivery, part charge is held together, and gypsum entirety is filled with mould, and gypsum blank mould completes, on blank mould plaster cast, make optical plastic substrate segmentation pallet, silicone rubber impression material secondary die, mould is filled with in gypsum segmentation, and segmentation denture gypsum completes;
4) by model spatial digitizer, every section of segmentation denture plaster cast is scanned, obtain initial data, save as respectively stl file;
5) adopt reverse engineering software-GeomagicQualify, carry out computer coupling segmentation denture, setting unit is millimeter;
6) software initial parameter is set, the stl file of selecting step 4, in software, form three-dimensional modeling view, then segmentation denture plaster cast 3-D view is mated to segmented model successively, if two sections of denture plaster cast 3-D views, adopt the method for " manual registration ", select " registration of n point ", a selected model is " fixing ", another model is elected " floating " as, on " fixing " model, be taken to the point of few 3 dispersions, comprise containing cheek, lingual surface and incisxal edge/cusp/jaw face, in " floating " model same position, mark same point, by " Register ", two segment models being realized substantially on locus overlaps, to ensure the coincidence of model on three-dimensional, carry out again " overall situation registration " and carry out meticulous coupling, check after average distance and standard deviation, two sections have the independent model registration of overlapping tooth position as a whole the most at last, if three sections of denture plaster cast 3-D views, adopt identical two sections of adjacent denture plaster casts of method coupling, mate with the 3rd section again, overlapping part between cutting remove model, obtain a complete dental arch model,
7) checking accuracy, taking the complete plaster cast of standard mandibular dentition as contrast groups, again the complete mandibular dentition model of three sections of registrations and the complete mandibular dentition plaster cast of standard are carried out after " registration " program of step 5, carry out " 3D comparison ", generate by " cloud atlas ", in cloud atlas, analyze its coincidence factor, thereby judge registration model whether with mouth in denture matching degree.
Two sections of described tooth positions are 37～42/41,47～32/31, three sections of tooth positions 37～33/44,34/35～44/45,43/44～47.
In described tailoring process, use " choosing thoroughly " function, at model lap, select non-anatomic landmark place as line of cut, delete the part overlapping between model, the optional two tooth adjoiners in non-anatomic landmark place.
After three described segment model registrations, overlapping part needs to delete, use " perspective " to observe the overlapping part of three segment models, avoid the important regions of anatomy such as cusp, use " straight line selection tool ", scale-up model, ensure that the shared picture of straight line is the narrowest, delete after this straight line, 1,3 two model has been divided into respectively two sections, delete its total part, complete the object that forms single " figure layer ", with 2,3 two models of method operation, finally formed a model that there is no lap.
Taking clinical case as embodiment, patient's mouth opening is about 1cm.
1) blank mould, alginate impression material is produced respectively upper and lower jaw die, and according to this patient's limitation of mouth opening situation, maxillary support disc can be put into mouth, can obtain complete model; And lower jaw pallet is due to the stopping of tongue, need row segmentation delivery, use the interim pallet of wax to divide 3 sections (as a37-33, b35-45, c43-47) to produce mandibular dentition die to lower jaw, by three sections of interim pallets of wax entirety that permeates, perfusion plaster cast;
2) make mandibular dentition individual tray, on mandibular dentition blank mould plaster cast, use optical plastic substrate to make 3 sections of individual trays, comprise that tooth position is respectively a:37-33, b:35-45, c:43-47, between two an at least overlapping complete tooth position between pallet;
3) secondary die: use silicone rubber impression material, produce respectively 3 sections of secondary dies of mandibular dentition with mandibular dentition segmented pallet, pour into respectively plaster cast;
4) scanning: the spatial digitizer that uses a model (Denmark 3shape, R700) scans 3 sections of plaster casts of mandibular dentition plaster cast respectively, saves as A.STL, B.STL, C.STL file;
5) computer coupling mandibular dentition: in GeomagicQualify2013, first mate two sections of adjacent mandibular dentition plaster casts, as A and B, open A.STL, B.STL file, carrying out " manual registration " in " alignment " tentatively mates it, select " registration of n point ", a selected model is " fixing ", another model is elected " floating " as, the point (comprising respectively cheek, lingual surface and incisxal edge/cusp/jaw face) that is taken to few 3 dispersions on " fixing " model marks same point in " floating " model same position. Realize both coincidences substantially by " Register ", average distance: 0.197541mm and standard deviation: 0.144074mm. Carry out " overall situation registration " and carry out meticulous coupling, average distance: 0.1425778mm and standard deviation: 159834mm, two sections have the independent model coordination of overlapping tooth position as a whole the most at last. By identical method, this entirety is mated with C, " manual registration " obtains average distance: 0.246417mm and standard deviation: 0.154022mm again; " overall situation registration " obtains average distance: 0.124366mm and standard deviation: 0.142794mm. Obtain thus a preliminary complete mandibular dentition model;
6) checking accuracy: taking standard mandibular dentition plaster cast as example, method for registering is the same, 1,2,3 three sections of gypsum dentures, first carry out 1,3 registrations (average distance: 0.108249mm and standard deviation: 0.037836mm), by Model registration (average distance: 0.145487mm and standard deviation: 0.053179mm) after 2 and 1,3 combinations, form complete model again. Again the complete mandibular dentition model of three sections of registrations and the complete mandibular dentition plaster cast of standard are carried out to 3D comparison, analyze its coincidence factor, thereby judge that whether registration model is consistent with denture situation in mouth. Should be noted that overlapping part after need deletion three segment model registrations forms single " figure layer ", otherwise cannot carry out 3D comparison herein. Concrete grammar is: uses " perspective " to observe 1,2,3 overlapping parts, avoids the important regions of anatomy such as cusp, use " straight line selection tool ", and scale-up model as far as possible, the narrowest to ensure the shared picture of straight line, to reduce error. Delete after this straight line, 1,3 two model has been divided into respectively two sections, deletes its total part, has completed the object that forms single " figure layer ". With 2,3 two models of method operation. The model that one of final formation does not have lap, carries out this model and master pattern after " registration " program (ditto), to carry out 3D comparison, generates by " cloud atlas ". In cloud atlas, can find out intuitively both matching degrees.