WO2009132483A1

WO2009132483A1 - Positioning and implanting method for oral orthodontic microimplant using direct measurement of interdental distance

Info

Publication number: WO2009132483A1
Application number: PCT/CN2008/001413
Authority: WO
Inventors: 姚英超
Original assignee: Yao Yingchao
Priority date: 2008-04-28
Filing date: 2008-08-01
Publication date: 2009-11-05
Also published as: CN101569535A; CN101569535B

Abstract

A 3D screen-like structure (3) is provided, which is made of x-ray impermeable materials and is provided with basic measuring units (2). When attached directly or indirectly to the gum astride the interdental fissure of two teeth at the cheek side or the tongue side in the oral cavity of a patient and parallel x-ray imaging is used, the interdental distance between two teeth can be measured on the x-ray images directly within the oral cavity of the patient, thus allowing the positioning of a microimplant to be determined immediately.

Description

Direct measurement of interdental distance and orthodontic micro-implant positioning

BACKGROUND OF THE INVENTION 1. In the orthodontics department, how do orthodontic micro-implants in the patient's mouth and X-ray film directly see how much space between the two teeth (interdental space), and immediately decide to micro-plant The body is intended to be implanted in position, and once the position is determined, the micro-plants are guided into the bone direction to reach the desired position at right angles under the guidance of the guiding sleeve. The root of the tooth will not be injured due to the patient's lying position or the angle of view of the doctor's operating position.

Background technique

The widespread use of orthodontic micro-implants is a matter of recent years. One of the biggest causes of failure is the injury to adjacent roots. This is a rough estimate of the traditional positioning method, plus the X-ray parallel illumination method, which is traditionally The orthodontic surgeon uses a 0.4-0.5 mm brass wire to tie the interdental fistula between the two teeth to be implanted into the micro-implant. Or fix the stainless steel wire on the orthodontic or the silk wire to take the X-ray online, then get a reference line on the X-ray film and then calculate the relative proportion with the actual stainless wire or brass wire, and then estimate Rough position. For example (Fig. 14), pre-drill or directly implant the micro-implants with a drill. For example (Fig. 15) (Fig. 20) (Fig. 21) where (Fig. 20) is taken from: Title Microimplants in Orthodontics, Press Dentos, Inc. Author: Jae-Hyun Sung, et al., Figure 4-34 on page 50.

Because no correct measurement is immediately presented on the X-ray film, the correct implantation position cannot be found immediately in the patient's mouth. The actual length of the reference line and the reference line must be calculated in proportion to the length of the X line, and then the distance is actually measured in the oral cavity. It is not only time-consuming and inaccurate, but also the reference line may be loosened in the patient's mouth due to poor fixation, or collided when X-ray examination is performed. Moreover, there is no scientific reproducibility. The X-ray of the first shot and the X-ray of the second shot cannot be in the same position because there is no fixed position.

In addition, when determining the position of the micro-implant, it is often determined by the physician's technical maturity that the guiding sleeve is not needed, because the direction of the implantation will be due to the operating position of the dentist and the angle of the patient lying on the chair. There is an error in the direction of the line of sight, resulting in a correct position, and the direction of implantation is not to damage the adjacent root. Therefore, for beginners, the guiding sleeve should be placed in the correct position to guide the micro-implant or the pre-drilled drill at right angles. Enter the alveolar bone between the two teeth. Summary of the invention

In order to solve the traditional diagnosis method, it is impossible to immediately determine how much interdental space is available for the micro-implant and immediately determine the position of the implanted micro-plant, so the material with X-ray opaque properties is used and has basic measurement. A unitary three-dimensional network structure is placed between the two teeth.

The material of the fixed three-dimensional network structure is an additive silicone rubber impression material or resin which is stamped by a general dentist, and is fixed on the occlusal surface of the tooth before the material is not hardened, and the X-ray to be used in the future can be used. The X-ray film holder (x-ray ho l der) of the parallel irradiation method marks the material, and in the future, when the patient receives the X-ray, the direction is ensured to be parallel.

After the patient receives the X-ray examination, it is clear on the X-ray film that the point is suitable for the implantation point of the micro-implant, and the distance between the two teeth.

The three-dimensional mesh structure is fixed on the occlusal surface of the tooth, and the basic measurement unit for removing the trimmed mesh structure in the patient's mouth can be repeatedly removed, and the original cavity is not changed in the oral cavity. Location, consistent with scientific repeatability.

The invention is fixed on the occlusal surface of the tooth, and allows the patient to perform pre-drilling or directly implanting the micro-implant in the occlusal state, and if the implant is 3-4 deep, the root is damaged, the disease The patient will have a different feeling and let the doctor know that there is something to do.

7毫米小格, want to implant the diameter of the micro-plant, once the position of the micro-implant is determined, the present invention has the same measurement unit size as the basic measurement unit or a multiple of the basic measurement unit size, such as the basic unit of measurement is 0. 7mm small grid, want to implant micro-implant diameter Is a 1. 2 awake, find the position to be implanted, if the bone is too hard, must be pre-drilled, using a non-removable guide sleeve diameter of 0. 5 匪 high about 4-5mm thick about 0. 2mm is pre-drilled on the square. If the thickness is 1. 2mm detachable, the thickness is 1. 2mm detachable. The guiding sleeve is guided, and then the implant is implanted under the guidance of the sleeve with a 1.2-sided self-threading implant.

The diameter of the sleeve is the same as the diameter of the drill or implant, the sleeve and the basic test The distance difference between the unit of measurement can be compensated by the thickness of the sleeve. Therefore, the guiding sleeve can be accurately and stably placed in the three-dimensional mesh structure without looseness, and the end of the sleeve is serrated, and the gum can be placed. The circular cutting is performed, so that along the guiding sleeve, regardless of the drill or the micro-implant, the desired direction can be entered at a right angle without being inaccurate due to the patient's lying posture and the doctor's operating angle. DRAWINGS

(Fig. 1) shows a mesh-like three-dimensional structure having a basic unit of measurement, which is applied with a soft wax on the buccal gingiva between the first permanent molar and the second premolar under the working plaster model.

(Fig. 2) shows that the networked three-dimensional structure is fixed to the tooth occlusal surface by an additive silicone rubber impression material. (Fig. 3) indicates that the X-ray film holder is positioned for parallel X-ray irradiation before the addition of the silicone rubber impression material is set.

(Fig. 4) indicates that the mark left by the X-ray holder is removed after the impression material has hardened.

(Fig. 5) means that the structure is removed and transferred to the patient's mouth, and the X-ray parallel method can still be maintained. (Fig. 6) shows the actual situation of measuring the mesh structure of the tibia with the basic measurement position in the actual human body and then taking the X-ray.

(Fig. 7) shows that the structure is removed and the dental drill is ground into a square having twice the basic unit of measurement.

(Fig. 8) indicates that the squares of the two basic units of measurement are worn away and then reinserted into the patient's mouth without changing the original position.

(Fig. 9) indicates that the self-threading implant is directly used to drill the orthodontic micro-implants from the positioned lattice.

(Fig. 10) shows that the detachable guide sleeve assists the orthodontic micro-implants to enter the positioning grid at right angles. (Fig. 11) shows that the drill (dri l l ) is guided by a non-detachable guiding sleeve into the positioning square at right angles. (Fig. 12) indicates drilling directly from the positioning square with the drill (dri l l).

(Fig. 13) shows the traditional way of tying brass wires between two teeth.

(Fig. 14) indicates that conventional implanted orthodontic micro-implants are implanted in a manner that approximates the approximate value of the brass line. (Fig. 15) shows a side view and a top view of the non-detachable guide sleeve.

(Fig. 16) shows the upper view when the detachable guide sleeve is closed and opened.

(Fig. 17) shows a side view of the detachable guide sleeve when it is closed.

(Figure 18) indicates the remake of the book Microimplants in Orthodontics, Press Dentos, Inc. Author: j _ae - Hyun Sung, et al., P. 50 Figure 4-34.

(Fig. 19) shows that the traditional brass wire is positioned in the actual human lower jaw bone, and then the actual situation is measured according to the X-ray. (Fig. 20) shows a photograph of a three-dimensional network structure directly attached to the oral cavity of a patient wearing a fixed appliance and receiving parallel X-ray irradiation.

(Fig. 21) shows the situation in which the three-dimensional network structure is displayed on the patient's X-ray film and immediately shows the point at which the point suitable for implantation into the micro-implant, the red table implantation point.

(Fig. 22) shows the situation in which the patient's mouth and X-ray films after implantation of the micro-implants show micro-implants.

Symbol Description

1. force-forming silicone rubber impression molding material additional si l icon impression material.

2. Basic measurement unit.

3. Positioning the three-dimensional network structure.

4. Orthodontic micro-embryo orthodontic implant.

5. Detachable guide bow When the sleeve is closed, the guiding guiding tube is closed stage.

6. Detachable guide sleeve handle handle of removable guiding tube

7. The mark of the x-ray film holder on the impression material marks of x-ray holder in impression material.

8. Orthodontic micro-ingrown silk driver screw driver for orthodontic implant.

9. The actual image of the three-dimensional mesh structure with the basic unit of measurement on the X-ray film.

10. Fixing wax wax

11. x-ray holder x-ray holder.

12. x-ray film x-ray f i lm.

13. Additive silicone rubber impression material is not hardened before additional si l icon Impression material before setting.

14. x-ray guide bow 1 x ray cone guide.

15. Drilling needle diamond bur.

16. Dental handpiece.

17. Two basic measured units.

18. Non-detachable guiding sleeve f ixed guiding tube.

19. Non-detachable guide sleeve handle. handle of f ixed guiding tube. 20. Drill (dril l).

21. Brass wire brass wire.

22. a toothed circular cut circular end with saw-like cutting edge

23. Detachable guiding sleeve opening guide guiding tube in open stage.

24. Indicates the point at which microprojections are selected for implantation.

detailed description

1. Indirect method: First, determine the position of the implanted orthodontic micro-implant in the patient's working plaster model. The diameter of the micro-implant is 1. 2mm micro-implant in the patient right Between the first permanent molar and the second premolar, first select a three-dimensional mesh structure of a suitable size and a basic measurement position, for example, the basic unit of measurement is 0. 7IM, the structure is fine-tuned to make it dense. Stick to the gums of different shapes (Figure 1) and then fix them on the gums of the plaster model with soft wax. The length is not to stimulate the oral mucosa and the mucosa of the mouth.

Find a x-ray Holder that will be used for X-ray parallel illumination in the future. Use a pencil on the model to mark the position where the X-rays can be illuminated in the future.

Prepare an additive silicone rubber impression material. After mixing, fix the net to the tooth occlusal surface (Fig. 2). Before the enamel material is not hardened, place the X-ray film holder on the impression material in parallel illumination. , leaving a mark on the impression material, and its position will not change in the future to the patient's mouth (Fig. 3) (Fig. 4).

Transfer the entire structure to the patient's mouth and take a parallel X-ray film. The X-ray film can determine which point is most suitable for micro-implant implantation (Fig. 5) (Fig. 6).

If the doctor thinks that the technique is not so good, it can be pre-drilled using a non-removable guiding sleeve (Fig. 15). (Fig. 11) and then the three-dimensional mesh structure is cut into a square mesh of 1. 4 mm X l. 4 mm. 2毫米的植。 The plaid as shown in Fig. 7 (Fig. 8), using a detachable implant sleeve (Fig. 16) (Fig. 17). Body, implant the implant along the sleeve (Fig. 10), and when the implant enters 3-4 mm, remove the detachable sleeve and implant the entire implant into the alveolar bone.

If the doctor feels that he is skilled and the implant direction is correct, he can directly drill the diameter of 0. 5mm from the square of the basic unit (dri ll) (Figure 12) and then remove the entire structure. Into 1. 2mm micro-implants.

If the doctor wants to use a self-threading implant with a diameter of 1. 2mm, then cut the center point of the implant into a 1. 4mmX l. 4mm square mesh lattice. Figure 7) (Figure 8), then implant the micro-tissions as shown (Figure 9).

2. Direct method: If there is no bracket on the surface of the patient's teeth, select a three-dimensional network structure of the appropriate size with the basic unit of measurement, and fix it on the surface of the tooth with a soft wax. If there is a bracket on the surface of the tooth. Trimming part of the net-shaped three-dimensional structure to avoid the bracket, and then fixing it on the bracket with soft wax, which can temporarily fix the mesh and fill the undercut on the bracket to facilitate future addition of silicon. The rubber impression material is fixed on the occlusal surface of the three-dimensional mesh, and then a parallel method X-ray (Fig. 20).

Find the most suitable position for the micro-implant on the X-ray film. In the medical record, the ninth grid from left to right, the sixth grid from top to bottom is the best implantation position, and then make a mark directly on the Internet ( Red (as shown in Figure 21) is the implantation point, using a diameter of 0. 7iM self-tapping orthodontic micro-implants, can implant micro-implants without the need of a sleeve guide, but also know the micro-implants Is the distance between the teeth sufficient (Figure 22).

The above example is that the basic unit of measurement is 0. 7mni, which is only an implementation example. Anyone familiar with the medical knowledge of the case makes equivalent changes or modifications according to the spirit of the invention, such as modifying the basic unit of measurement, or modifying The shape of the mesh should be covered by the following claims in this case.

Claims

Claim

1. A three-dimensional network structure having a basic unit of measurement made of radio-opaque material, attached to the buccal or lingual gingival between the teeth of the patient's mouth by direct or indirect methods. By parallel X-ray irradiation, the distance between the two teeth and the position of the micro-plants can be directly measured on the X-ray film and in the patient's mouth.

2. In conjunction with the above-mentioned positioning measurement mesh structure, there are separate detachable guide sleeves and non-detachable guide sleeves. There are serrations on both ends of the sleeve to cut the gum tissue. The detachable sleeve is used to guide the direct implantation of micro-implants or pre-drilled drills (dri ll) into the 3-4 mm, the direction is correct, remove the detachable sleeve and continue implanting or drilling. Because the diameter of the micro-implant head of all brands in the world must be greater than the diameter of the implant or the diameter of the sleeve. The non-removable guide sleeve is only used to guide the pre-drilled (pre- dr i 11) alveolar bone, the diameter of which is the diameter of the pre-drilled drill.

3. The diameter of the sleeve can be determined by the basic unit of measurement or its multiple unit of basic measurement, for example: 2 times, 3 times, and the diameter of the micro-implant to be implanted or the diameter of the pre-drilled drill. The sleeve can be tightly placed into the mesh without looseness, and the distance between the sleeve and the mesh can be compensated by the thickness of the sleeve to be closely placed in the three-dimensional mesh structure.