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[0002] In odontology, there exist currently various methods and mechanical devices intended to effect the filling of loss of dental tissue substance due to caries or to other causes, and for the creation of crowns or other devices.
[0003] At present in the case of caries or alteration of dental tissues, the dentist, in order to eliminate the carious or altered portion, removes the damaged elements by means of a drill or of an excavator and forms, using the aforementioned instruments, a housing, a preparation into which he introduces either a plastics material: amalgam with a mercury and silver base, resin, specific composite materials, or a metal casting obtained by the disposable wax method or ceramic and composite inlay after the recording of this preparation by impression compound, the two parts being produced by the dental prosthesis laboratory. The amalgams for odontological use have the disadvantage of employing materials of which the subsequent spread in the ambient surroundings is ill-controlled especially in relation to pollution due to mercury. In the case of composite resins, these have a significant rate of contraction giving rise to percolation, thus micro fissures start to form, altering the water-tightness of the filling and admitting septic liquids (saliva), which can lead to an alteration of the hard tissues of the tooth.
[0004] More recent equipment also exists for the production of inlays, onlays or ceramic crowns, for which the measurement is carried out by means of a video camera. Prior to the video analysis, the dentist must spread a white powder on the regions of the cavity to be analysed, and this in the mouth. This powder is subject to the laws of gravity and is more difficult to use in the maxilla than in the mandible. Next a video camera analyses the shades of grey in the region which has been scanned. Computer software evaluates the borders of the cavity, the different depths and it determines in this way the volume as a function of these shades of grey. Next the operator delimits electronically by means of a mouse, the lateral borders of the floor of the cavity and the juxta-gingival limits of the tooth in order to produce the desired type of dental reconstruction. This process is not very accurate in view of the measurement technology used and it has numerous disadvantages. The analyses of shades of grey give a poor level of precision, especially in relation to the shaded areas which are totally inaccessible to analysis by this process. Then the lateral limits of the site of the reconstruction are not precise limits of the defined site but a simple site given by the operator without taking account of the aspects of roughness and of the precise location in space of the preliminary work carried out by the dentist. The peripheral juxta-gingival limits of the tooth are not well-defined either for they are determined in an arbitrary manner by the operator. The proximal and occlusal surfaces come from a computer data bank which holds in its memory numerous tooth profiles. As regards the geometric location in space, there is no fixed position reference link in the space between the video camera used for taking the shots and the cavity in question, for these shots are taken with a hand-held camera. Nor is account taken of the profiles of the antagonist teeth which will be positioned exactly opposite the implanted element.
[0005] Other systems exist of digitisation or of recording of the contours of prosthetic preparation with a recording probe fitted with a simple sensor or with a sapphire needle; the preparation being mounted on a turntable, it is sometimes centred by a laser diode. This process requires physical contact between the sensor or the sapphire needle and the preparation which excludes recording of materials of weak mechanical resistance, soft materials in effect.
[0006] The present invention proposes to remedy these disadvantages by proposing a method of producing high-geometric-precision implant elements made from a neutral material and intended to fill by means of different types of reconstruction the damage caused by caries or alteration of dental tissues, or intended for the production of high-precision partial or full dental crowns, or other implanted dental devices, involving direct or indirect measurements, which are transmitted or not to a prosthetic technician by electronic means.
[0007] To this end and more precisely, the present invention relates to a method of producing high-geometric-precision implant elements made from a neutral material and intended to fill by means of different types of prosthetic reconstruction the damage caused in the teeth by dental caries or alteration of tissues having other causes, or intended for the production of high-precision dental crowns, or other implanted dental devices, a method characterised in that:
[0008] a model which is designed to fill missing dental tissue which has been destroyed is produced, either in vivo by updating and defining a new volume which is bordered by healthy tissue and has the shape of a tapered wall, or in vitro by taking an impression in the mouth of a dental preparation using an impression compound, this impression then being cast in plaster and, from this positive plaster model, updating and defining a new volume,
[0009] then a measurement of this model is taken in 3-D by means of a three-dimensional measuring apparatus with light wavefront analysis, a volume analysis carried out by means of shots, a projector being positioned at an angle to a camera, the projector and the camera being mechanically and geometrically linked to a revolving platform that is used to support the model by means of a frame in order to obtain a good triangulation,
[0010] followed by electronic processing to remodel the sections of volumes among themselves,
[0011] then an electronic modification of the files to determine exactly the desired profile,
[0012] then a machining of the final element to be implanted with a digitally-controlled machine.
[0013] The advantages obtained are: production of implant parts of a neutral nature which are non-polluting both while they are in the mouth and when they are removed, a high degree of precision in the finished element which can be close to two-hundredths of a millimetre, speed and ease of implementation.
[0014] This method can be implemented in two ways, especially in odontology: either based on a model made in the mouth (in vivo), or in vitro: from a conventional dental impression, the model is produced directly in the laboratory.
[0015] The present invention will be better understood by reading the detailed description which follows with reference to the annexed drawings and giving by way of example, which is indicative but in no way restrictive, one embodiment of the invention.
[0016] On the drawings:
[0017]
[0018] With reference to
[0019] In order to implement the method, it is necessary in the first place to construct a model aimed at filling the loss or losses of substance from the dental organ or organs. This model may be produced in two ways, either directly in the mouth, mode A, or in the prosthesis laboratory, mode B, after taking an impression of the loss of substance by means of a conventional material (alginate, silicone or other). This impression will be processed in the prosthesis laboratory in such a way as to obtain a positive mould.
[0020] In the first mode A, the dentist, in operation
[0021] The second mode B consists in taking an impression in the mouth of the dental preparation by using conventional impression compound and in a conventional and customary method in dentistry, then this impression is cast in plaster and, from this positive model, the first, already described, mode is rejoined to arrive at the new volume
[0022] Based upon the new volume
[0023] The assembly of rod
[0024] The “OptoTOP” machine uses a system of 3-D metrology in which the shots are recorded and analysed in three dimensions. The operation of the “OptoTOP” system is based on a principle of optical triangulation: topometry which uses a projection of structured and phase-offset white light.
[0025] For this purpose, a luminous rectangular pattern constructed from a plurality of luminous bands is projected on the model
[0026] These files are then either compared with other files or manually modified by means of software for correcting or refreshing volume
[0027] In this spirit, one of three known types of digitally-controlled machine can be used, for example: a digitally-controlled machine operating on three axes, four axes or five axes. When using a digitally-controlled machine on three axes, it will be necessary to proceed by reversal of the part to be machined. When using a digitally-controlled machine on four axes, in circular mode, the machining of the sized part to be machined
[0028] The product of this machine then is a part
[0029] On the same principle, the method can be applied also to the production of prosthetic dental crowns produced from the second mode B described above. Starting with the positive model, firstly a 3-D recording is produced of the stump, which may or may not be coated with a thickness-compensating varnish. Secondly, after intervention by the dental prosthetist, and presentation of the antagonist moulds, a recording of the cap realised in hard or soft, opaque material is produced.
[0030] The 3-D recording software
[0031] At the end of this process, a virtual volume is obtained which defines the intrados and the extrados of the final cap or crown, to be machined.
[0032] For the bridges which are an assembly of caps and bridging pieces, the method uses again all the elements described above for the models and crowns, these volumes being linked.
[0033] The present invention has the advantage that a high degree of precision in the implanted elements is obtained, with the possibility of an effective neutrality of these elements, made out of diverse materials such as ceramics, marble, ordinary stone, precious stone, coloured material etc., with a high degree of compatibility between the contacts of the surfaces of the antagonist teeth and adjacent teeth.
[0034] It goes without saying that the invention has been described above by way of preferred example, which is indicative but not restrictive, and that it is possible to introduce any equivalence in its constituent elements without departing from the framework defined by the annexed claims.