Abstract
A dental overlay device includes a base, connecting strut, and veneer holder. The base has a curvature in the form of an arch of a patient and defines a curved axis. The connecting strut has a first end attached to the base and a second end and extends in a generally orthogonal direction to the curved axis. The veneer holder has first and second ends and extends in a transverse direction to the direction the connecting strut extends. The second end of the connecting strut is attached to the veneer holder. A dental overlay device and veneer combination includes a first veneer and a second veneer prepared for mounting onto the plurality of teeth. Floss is configured for passing between the first veneer and the second veneer when the dental overlay device is mounted onto the plurality of teeth.
Claims
1. A method for treating working teeth in the mouth of a patient, the method comprising: placing a dental overlay device and veneer combination onto a plurality of teeth of a patient such that a first veneer and a second veneer of the dental overlay device and veneer combination are mounted onto the plurality of teeth; and flossing between the first veneer and the second veneer with the dental overlay device placed onto the plurality of teeth.
2. The method of claim 2, wherein the dental overlay device and veneer combination includes a first veneer and a second veneer adjacent to the first veneer, and wherein the first and the second veneers rest on respective adjacent and spaced apart first and second supports of the dental overlay device, each of the first and the second supports extending from a base of the dental overlay device.
3. The method of claim 1, further comprising: aligning the first veneer with a first tooth of the plurality of teeth by the placing step such that the first veneer covers at least a majority of a buccal side of the first tooth; and aligning the second veneer with a second tooth of the plurality of teeth by the placing step such that the second veneer covers at least a majority of a buccal side the second tooth.
4. The method of claim 3, further comprising flossing between the first tooth and the second tooth while the dental overlay device is placed onto the plurality of teeth.
5. The method of claim 4, wherein a bonding agent is removed from between the first tooth and the second tooth by the step of flossing between the first tooth and the second tooth.
6. The method of claim 1, wherein a bonding agent is removed by the flossing step.
7. The method of claim 1, wherein the flossing step includes passing floss between first and second supports of the dental overlay device, the first and the second supports being aligned with the first and the second veneers, respectively.
8. The method of claim 7, wherein the first and the second supports extend from a base in a transverse direction orthogonal to mesial-distal directions within the mouth of the patient such that the floss is passed from a buccal side to a lingual side of a dental arch of the patient that includes the teeth on which the dental overlay device is placed.
9. The method of claim 7, wherein one or both of the first and the second supports is in the shape of a T.
10. The method of claim 1, further comprising passing a probe between first and second supports of the dental overlay device, each of the first and the second supports extending from a base of the dental overlay device.
11. The method of claim 1, wherein the dental overlay device and veneer combination is placed such that an inner surface of the dental overlay device remains releasably fixed to a plurality of teeth in the same position relative to the plurality of teeth upon application of pressure to the dental overlay device and veneer combination during the flossing step.
12. A dental overlay device configured for placing one or more veneers on a corresponding working tooth or corresponding working teeth in the mouth of a patient, comprising: a base having a curvature substantially in the form of an arch of the patient, the base defining a curved axis; a connecting strut having first and second ends and extending in a generally orthogonal direction to the curved axis, the first end being attached to the base; and a veneer holder having first and second ends and extending in a transverse direction to the direction that the connecting strut extends, wherein the second end of the connecting strut is attached to the veneer holder.
13. The dental overlay device of claim 12, wherein the connecting strut is attached to a central portion of the veneer holder.
14. The dental overlay device of claim 12, wherein the veneer holder is a receptacle configured for holding a veneer in position during placement of the veneer onto a corresponding working tooth.
15. The dental overlay device of claim 12, wherein the base comprises: a main body; a first extending portion extending from the main body and spaced from the connecting strut and the veneer holder to define a first channel; and a second extending portion extending from the main body and spaced from the connecting strut and the veneer holder to define a second channel, the first channel and the second channel being on opposite sides of the connecting strut and on opposite sides of the veneer holder.
16. The dental overlay device of claim 12, wherein the veneer holder extends in mesial-distal directions when the dental overlay device is placed in the mouth of the patient.
17. The dental overlay device of claim 12, wherein the first and the second ends of the veneer holder are free ends.
18. The dental overlay device of claim 12, wherein the connecting strut and veneer holder define a first support for a first veneer, the dental overlay device further comprising: a further connecting strut extending in a generally orthogonal direction to the curved axis; and a further veneer holder attached to the further connecting strut and extending in a transverse direction to the direction that the further connecting strut extends, the further connecting strut and the further veneer holder defining a second support for a second veneer.
19. The dental overlay device of claim 18, wherein the distance between the connecting strut of the first support and the further connecting strut of the second support is at least 3 mm.
20. The dental overlay device of claim 12, wherein the base is a wrap portion of the dental overlay device having a customized inner surface conforming to a plurality of attachment teeth of the patient's teeth, the attachment teeth being different from the working tooth or working teeth, such that the dental overlay device remains releasably fixed to the attachment teeth in the same position relative to working tooth or the working teeth upon application of pressure to the dental overlay device.
21. A dental overlay system for the placement of one or more veneers into the mouth of a patient, comprising: one or more veneers; and the dental overlay device of claim 12.
22-41. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0083] A more complete appreciation of the subject matter of the present technology and the various advantages thereof may be realized by reference to the following detailed description which refers to the accompanying drawings, in which:
[0084] FIG. 1 is a functional diagram in accordance with an embodiment;
[0085] FIG. 2 is an elevation view of a computer-aided drawing (CAD) model of a scanned physical 3D model of teeth;
[0086] FIG. 3 is a plan view of the CAD model of FIG. 2 following the correction of errors in the model in accordance with an embodiment;
[0087] FIG. 4A is a plan view of the CAD model of FIG. 3 following remeshing of the CAD model;
[0088] FIG. 4B is a plan view of the CAD model of FIG. 4A after refreshing of the CAD model;
[0089] FIG. 5 is a plan view of the CAD model of FIG. 4B after importation into a solid model building application in accordance with an embodiment;
[0090] FIG. 6 is a partial plan view of the CAD model of FIG. 5 with the addition of a working plane marker to the model;
[0091] FIG. 7 is a partial perspective view of the CAD model of FIG. 5 with the addition of tool markers to the model;
[0092] FIG. 8 is a partial perspective view of a modified version of the CAD model of FIG. 5 modeling prepared working teeth and the addition of a tool path marker to the model;
[0093] FIG. 9 is a partial perspective view of the CAD model of FIG. 5 in which the tool path marker shown in FIG. 8 has been adjusted;
[0094] FIG. 10 is a partial perspective view of a modified version of the CAD model of FIG. 5 highlighting cuts to modeled prepare working teeth for validation by a user;
[0095] FIG. 11 is a partial perspective view of a modified version of the CAD model of FIG. 5 with the addition of an in-process digital guide body outer shell in accordance with an embodiment;
[0096] FIG. 12 is a partial perspective view of the CAD model of FIG. 11 with the addition of a digital cutting tool surrogate to the digital guide body outer shell;
[0097] FIG. 13 is a perspective view of the CAD model of FIG. 5 with the addition of boundary markers in accordance with an embodiment;
[0098] FIG. 14 is a perspective view of a CAD model of a digital tooth wrap in accordance with an embodiment;
[0099] FIG. 15 is a perspective view of a CAD model of an in-process digital guide device in accordance with an embodiment;
[0100] FIG. 16 is a perspective view of a CAD model of a digital guide device prepared with the in-process digital guide device of FIG. 15 being compared with the teeth of the CAD model of FIG. 5 in accordance with an embodiment;
[0101] FIG. 17 is a perspective view of a physical guide device in accordance with an embodiment;
[0102] FIG. 18 is a perspective view of a physical guide device in accordance with an embodiment;
[0103] FIGS. 19A and 19B are perspective views of the inside of the mouth of patient prior to and after preparation of the patient's teeth, respectively, in accordance with an embodiment;
[0104] FIGS. 20A and 20B are process flow diagrams of processes for preparing the teeth of a patient to receive a restoration in accordance with embodiments;
[0105] FIG. 20C is a perspective view of a CAD model of a dentition of a patient with an emplaced plane in accordance with an embodiment;
[0106] FIG. 20D is a perspective view of the CAD model of the dentition of the patient of FIG. 20C in conjunction with an emplaced spline in accordance with an embodiment;
[0107] FIGS. 20E and 20F are perspective views of the CAD model of the dentition of the patient of FIG. 20C in conjunction with CAD models of a cutting tool and tool path in accordance with embodiments;
[0108] FIG. 20G is a perspective view of the CAD model of the dentition of the patient of FIG. 20C in conjunction with a CAD model of a spline being edited in accordance with an embodiment;
[0109] FIG. 20H is a perspective view of the CAD model of the dentition of the patient of FIG. 20C in conjunction with a distance checking tool in accordance with an embodiment;
[0110] FIG. 20I is a perspective view of the CAD model of the dentition of the patient of FIG. 20C in conjunction with CAD models of a cutting tool and tool path in accordance with an embodiment;
[0111] FIG. 21 is a plan view of a graphical user interface (GUI) during the importation of CAD models of the teeth of a patient including prepared working teeth and of a restoration into the specialty tool package to form a digital restored 3D model in accordance with an embodiment;
[0112] FIG. 22 is a plan view of the CAD models of the teeth of the patient and of the restoration imported using the graphical user interface shown in FIG. 21;
[0113] FIGS. 23A and 23B are elevation and plan views, respectively, of modified CAD models of the digital restored 3D model of FIG. 22 in accordance with an embodiment;
[0114] FIGS. 24A-24C show process steps during the transformation of the modified CAD model of FIGS. 23A and 23B from a digital clay model to a restored 3D buck model in accordance with an embodiment;
[0115] FIGS. 25A and 25B are perspective and plan views, respectively, of the restored 3D model of FIGS. 24B and 24C along with the addition of a boundary line for a digital primary support in accordance with an embodiment;
[0116] FIG. 26 is a plan view of the restored 3D model of FIG. 25B with the addition of a boundary line for a digital lingual auxiliary support in accordance with an embodiment;
[0117] FIGS. 27A and 27B show process steps for embossing digital support teeth to form the digital primary support of an in-process digital placement tray in accordance with an embodiment;
[0118] FIG. 28 shows a process step for embossing a digital lingual side of digital working teeth to form the digital lingual auxiliary support onto the in-process digital placement tray of FIG. 27B in accordance with an embodiment;
[0119] FIG. 29 shows a process step for forming a digital intersection of the in-process digital placement tray of FIG. 28 between the digital primary support and the digital lingual auxiliary support in accordance with an embodiment;
[0120] FIG. 30 shows process step for smoothening the digital intersection of the in-process digital placement tray prepared by the process illustrated in FIG. 29 and portions of the digital primary support and the digital lingual auxiliary support around the digital intersection in accordance with an embodiment;
[0121] FIGS. 31A and 31B show elevation views of the in-process digital placement tray of FIG. 30 along with the addition of a boundary line for a digital buccal auxiliary support in accordance with an embodiment;
[0122] FIG. 32 shows the in-process digital placement tray of FIG. 31B with the addition of embossing to the digital buccal side of digital working teeth to form a digital buccal auxiliary support onto the in-process digital placement tray;
[0123] FIG. 33A is a partial elevation view of a digital intersection added onto the in-process digital placement tray of FIG. 32 between the digital primary support and the digital buccal auxiliary support in accordance with an embodiment;
[0124] FIG. 33B is a plan view of the digital primary support, digital buccal auxiliary support, and the digital intersection therebetween of the in-process digital placement tray of FIG. 33A after being smoothened in accordance with an embodiment;
[0125] FIGS. 34A and 34B are plan and elevation views, respectively, of the in-process digital placement tray of FIG. 33B with the addition of digital connector supports in accordance with an embodiment;
[0126] FIG. 35 shows a process step for diving the in-process digital placement tray of FIGS. 34A and 34B from the restored 3D buck model of FIGS. 24B and 24C in accordance with an embodiment;
[0127] FIG. 36 shows a process step for cleaning the in-process digital placement tray shown in FIG. 35 in accordance with an embodiment;
[0128] FIG. 37 is a plan view of the final digital placement tray after the cleaning step shown in FIG. 36 in accordance with an embodiment;
[0129] FIG. 38 shows a step of manipulating the data associated with the final digital placement tray of FIG. 37 to form a data file for use with a fabrication device in accordance with an embodiment;
[0130] FIG. 39 shows an additive manufacturing machine that may be used to form a physical placement tray corresponding to the final digital placement tray of FIG. 37 in accordance with an embodiment;
[0131] FIGS. 40A-40E are perspective views of physical placement trays in accordance with various embodiments;
[0132] FIG. 40F is a front, top, right perspective view of a dental restoration placement tray in accordance with an embodiment;
[0133] FIG. 40G is a front elevation view of the dental restoration placement tray of FIG. 40F;
[0134] FIG. 40H is a rear elevation view of the dental restoration placement tray of FIG. 40F;
[0135] FIG. 40I is a right side elevation view of the dental restoration placement tray of FIG. 40F;
[0136] FIG. 40J is a top plan view of the dental restoration placement tray of FIG. 40F;
[0137] FIG. 40K is a bottom plan view of the dental restoration placement tray of FIG. 40F;
[0138] FIG. 40L is a top, rear, left perspective view of the dental restoration placement tray of FIG. 40F;
[0139] FIG. 40M is a left side elevation view of the dental restoration placement tray of FIG. 40F;
[0140] FIG. 40N is an environmental view showing an example use of the dental restoration placement tray of FIG. 40F on an example tooth mold with example veneers;
[0141] FIG. 40O is a front, top, right perspective view of a dental restoration placement tray and assembly in accordance with an embodiment;
[0142] FIG. 40P is a front elevation view of the dental restoration placement tray of FIG. 40O;
[0143] FIG. 40Q is a rear elevation view of the dental restoration placement tray of FIG. 40O;
[0144] FIG. 40R is a left side elevation view of the dental restoration placement tray of FIG. 40O;
[0145] FIG. 40S is a top plan view of the dental restoration placement tray of FIG. 40O;
[0146] FIG. 40T is a bottom plan view of the dental restoration placement tray of FIG. 40O;
[0147] FIG. 40U is a top, rear, left perspective view of the dental restoration placement tray of FIG. 40O; and
[0148] FIG. 40V is a right side elevation view of the dental restoration placement tray of FIG. 40O;
[0149] FIG. 40W is an environmental view showing an example use of the dental restoration placement tray and assembly of FIG. 40O on an example tooth mold;
[0150] FIG. 41 is a perspective view of a physical placement tray system in preparation for the application of veneers to the teeth of a patient in accordance with an embodiment;
[0151] FIGS. 42A and 42B are perspective views of physical placement tray system of FIG. 41 being applied to the teeth of a patient and following application to the teeth of the patient, respectively, in accordance with an embodiment;
[0152] FIGS. 43A and 43B are perspective views of the teeth of a patient before and after placement of the veneers of the physical placement tray system of FIG. 41; and
[0153] FIG. 44 is a process flow diagram of a process for preparing a placement and retention device for applying a restoration to the teeth of a patient in accordance with an embodiment.
DETAILED DESCRIPTION
[0154] Where reference is made herein to a method comprising two or more defined steps, the defined steps can be carried out in any order or simultaneously (except where the context excludes that possibility), and the method can include one or more other steps which are carried out before any of the defined steps, between two of the defined steps, or after all the defined steps (except where the context excludes that possibility).
[0155] The terms “lower,” “upper,” “top,” “bottom,” and variations of such terms as well as derived directional terms such as “horizontal,” “vertical,” “upward,” and “downward” are based on a normal configuration of an overlay as shown in the drawings, in which the overlay is fitted onto the lower teeth of a patient with the roots of the teeth extending vertically downward. The term “dentist” in this text is not to be interpreted restrictively and can also be read as dental practitioner, dental technician, dental assistant, dental hygienist, dental auxiliary, dental therapist, dental designer, etc.
[0156] According to conventional techniques, a diagnostic evaluation of a tooth reveals an existing condition requiring a tooth to be treated by the installation of a restoration or prosthesis. Under these conventional approaches, the tooth to be treated is revised and prepared first, and then its revised configuration is used to fabricate the internal configuration of the restoration. Therefore, the restoration is fabricated to fit the already prepared tooth.
[0157] In accordance with an embodiment of the present technology, as with such conventional approaches, a dentist may identify by either or both of x-ray and other diagnostic techniques portions of an existing working tooth of a patient that should be removed, due to e.g., decay, cracks, weaknesses, dislocations, deformities, impediments to bite, or other maladies or undesirable aspects of the tooth. In some arrangements, the dentist may then prepare a physical 3D model, which preferably may be any one or a combination of a cast, a mold, and an impression, of the entire lower or entire upper set of teeth in the patient's mouth that include the working tooth and a neighboring tooth or neighboring teeth of the working tooth, although in some instances the physical 3D model may only include a portion of the lower or the upper set of teeth as the case may be.
[0158] Referring now to the drawings, the prepared physical 3D model then may be digitally scanned with a scanning device by the dentist, such as with but not limited to being with a handheld 3D scanner or other scanning devices such as those by Imetric 3D providing photogrammetry and structured light scanning, to create original tooth data 125 to be stored in memory 124 of first client computer 120, as referenced in FIG. 1, corresponding to a scanned topography of the physical 3D model including a model of the working tooth to be treated. In some other arrangements, the dentist may directly scan, e.g., with a handheld 3D scanner, all or a portion of the lower or upper set of teeth including the working tooth in the patient's mouth to create original tooth data 125. Alternatively, the dentist may send the physical 3D model to a third party, which preferably may be, or may work in conjunction with, a second user of second client computer 130 described further herein and further referenced in FIG. 1, who or which may digitally scan the physical 3D model prepared by the dentist to create original tooth data 125.
[0159] A system for preparing instrumentation to assist in the preparation of one or more working teeth to receive a restoration, for the actual preparation of the one or more working teeth to receive the restoration, for preparing the restoration, and for placing the restoration is provided.
[0160] As further shown in FIG. 1, system 105 may be used, among other functions, to generate, store and share data corresponding to three-dimensional models of structures, such as but not limited to teeth. System 105 may include at least one server computer 110, first client computer 120, and at least second client computer 130 which may be located remotely from the first client computer. Each of these computers may send and receive information via network 140.
[0161] Network 140, and intervening communication points, may include various configurations and protocols including the Internet, World Wide Web, intranets, virtual private networks, wide area networks, local networks, private networks using communication protocols proprietary to one or more companies, Ethernet, WiFi and HTTP, and various combinations of the foregoing. Communications among these configurations and applying these protocols may be facilitated by any device configured for transmitting data to and from other computers, such as modems (e.g., dial-up, cable, or fiber optic) and wireless interfaces. Although FIG. 1 illustrates only a few devices, system 105 may include a large number of connected computers, with each different computer being at a different communication point of the network.
[0162] Computers 110, 120, 130 each may include a processor and memory. For example, server 110 may include memory 114 which stores information accessible by processor 112, first client computer 120 may include memory 124 which stores information accessible by processor 122, and second client computer 130 may include memory 134 which stores information accessible by processor 132. Each of processors 112, 122, 132 may be any conventional processor, such as commercially available central processing units (CPUs). Alternatively, any of processors 112, 122, 132 may be dedicated controllers such as an ASIC, FPGA, or another hardware-based processor. Although shown in FIG. 1 as being within the same block, each processor and its corresponding memory may actually comprise multiple processors and memories that may or may not be stored within the same physical housing. For example, memories may be a hard drive or other storage media located in a server farm of a network data center. Accordingly, references to a processor, memory, or computer will be understood to include references to a collection of processors, memories, or computers that may or may not operate in parallel.
[0163] Each of memories 114, 124, 134 may include first part storing applications or instructions 116, 126, 136 that may be executed by the respective processor. Instructions 116, 126, 136 may be any set of instructions to be executed directly (such as machine code) or indirectly (such as scripts) by the processor. In that regard, the terms “applications,” “instructions,” and “programs” may be used interchangeably herein. The memories may also include second part storing data 118, 128, 138 that may be retrieved, stored or modified in accordance with the respective instructions. The memory may include any type configured for storing information accessible by the processor, such as a hard-drive, memory card, ROM, RAM, DVD, CD-ROM, write-capable, and read-only memories or various combinations of the foregoing, where instructions or applications 116, 126, 136 and corresponding data 118, 128, 138 are stored on the same or different types of media.
[0164] For example, the dentist or the referenced third party may store original tooth data 125 of data 128, once generated, within memory 124 of first client computer 120. Generated original tooth data 125 may then be uploaded to server 110 and distributed via network 140 to second client computer 130. Alternatively, when the third party is or works in conjunction with the second user of second client computer 130, original tooth data 125 may be received by second client computer 130 directly from the scanning device used to scan the topography of the lower or upper set of teeth of the patient or of the physical 3D model of such teeth (hereinafter referred to as the “scanned tooth topography”), as the case may be.
[0165] In addition to a processor, memory and instructions, client computers 120, 130 may have all of the components used in connection with a personal computer. For example, the client computers may include electronic display 127, 137 (e.g., a monitor having a screen, a touch-screen, a projector, a television, a computer printer or any other electrical device that is operable to display information including but not limited to a smartphone or other similar handheld device), one or more user inputs (e.g., a mouse, keyboard, touch screen and/or microphone), one or more sound outputs such as speakers, and all of the components used for connecting these elements to one another.
[0166] As further shown in FIG. 1, at least instructions 136 of second client computer 130 may include building application 135, or alternatively solid model building application 135A. The building application may be computer-aided design (CAD) 3-D modeling software or equivalent as known in the art, which preferably may be but is not limited to being GEOMAGIC FREEFORM by 3D Systems, Inc. or SOLIDWORKS® by SolidWorks Corporation but may also be other similar software programs such as but not limited to Autodesk® AutoCAD®, Creo® by Parametric Technology Corporation (formerly Pro/Engineer), Siemens PLM Software NX™ (formerly Unigraphics NX), and CATIA® by Dassault Systemes. After receiving original tooth data 125, building application 135 may execute instructions, among other instructions it may execute, to convert the original tooth data into digital 3D model 139 which may be a wireframe structure in the form of the scanned topography of either or both of a lower and an upper set of teeth of the patient (which may be a scanned topography of the physical 3D model) including the working tooth to be treated. In this manner, 3D model 139 may be viewable on electronic display 137, such as within a graphical user interface (GUI) of building application 135, and modifiable with a user input by a second user, who or which may be the first user or a different user from the first user, using building application 135.
[0167] In some arrangements, instructions 126 of first client computer 120 may also include a building application, and in some such arrangements, this building application may be the same as building application 135. In this manner, in such arrangements, first client computer 120 may convert original tooth data 125 into digital 3D model 139 for viewing or possible modification of the model before uploading the original tooth data or a modified version of the original tooth data to server 110. Either or both of building application 135 of second client computer 130 and any building application stored in memory 124 of first client computer 120 further may be associated with a GUI for displaying digital 3D model 139 on a client device in order to allow the user to utilize the functions of the building applications.
[0168] Data 118, 128, 138 need not be limited by any particular data structure. For example, the data may be stored in computer registers, in a relational database as a table having a plurality of different fields and records, or XML documents. The data also may be formatted into any computer-readable format such as, but not limited to, binary values, ASCII or Unicode. Moreover, the data may comprise any information sufficient to identify the relevant information, such as numbers, descriptive text, proprietary codes, pointers, references to data stored in other memories (including other network locations) or information that is used by a function to calculate the relevant data. For example, data 138 of second client computer 130 may include information used by building application 135 to create 3D model 139.
[0169] In addition to the operations described above and illustrated in the figures, various other operations will now be described. It should be understood that the following operations do not have to be performed in the precise order described below. Rather, various steps may be handled in a different order or simultaneously. Steps also may be omitted or added unless otherwise stated herein.
[0170] Part 1: Digital Preparation of Preparation Guide Devices for Preparing a Working Tooth to be Treated.
[0171] Referring now to FIGS. 2-16, building application 135 is retrofitted with a specialty tool package that allows digital preparation of computer-generated models of tooth structure and corresponding preparation guide devices, which may be configured to fit and cooperate with a custom handpiece. In the example shown, building application 135 is GEOMAGIC FREEFORM by 3D Systems, Inc.
[0172] As shown in FIG. 2, original digital 3D model 139 is imported by processor 132 into the specialty tool package. Excess regions of the digital 3D model that are unneeded for preparing the preparation guide devices may then be trimmed from the 3D model, as in the example shown, eliminating excessive data that may slow down the CAD software.
[0173] As shown in FIG. 3, the user, e.g., the second user, of building application 135 may then use the specialty tool package to check digital 3D model 139, or such model after trimming, for suspected errors in the 3D model that may be but are not limited to being caused by any one or any combination of a poor resolution of the scanned tooth topography whether directly from the patient's mouth or from a 3D physical model, a poor resolution of the 3D physical model of the tooth to be treated, and voids or extraneous projections in the physical model. As shown, 3D model additional structure 145 corresponding to tooth addition data may be identified for addition to any undesired voids identified in original digital 3D model 139, and any undesired projections identified in the digital 3D model are selected for removal from the original digital 3D model. The audit check and identification of needed error corrections may be performed by the processor using building application 135. The user of building application 135 may then provide an input, such as by clicking an icon on a GUI of the building application to accept the additional structure 145 and as well as the removal of undesired projections. As shown in FIGS. 4A and 4B, original 3D model 139 may be remeshed into a single mesh, including meshing with 3D model additional structure 145, and refreshed to form new remeshed digital 3D model 139A′ and new (refreshed) digital 3D model 139A corresponding to new tooth data 125A. In preferred alternative arrangements, errors in original digital 3D model 139 may be automatically repaired upon importing the original digital 3D model into the specialty tool package of building application 135, as well as after subsequent trimming of the original digital 3D model to form new digital 3D model 139A. As shown in FIG. 5, new digital 3D model 139A is imported into a specialty tool package of a solid model building application 135A.
[0174] As shown in FIG. 6, working plane 147 is set at an appropriate position and orientation relative to the digital model of the working tooth to be treated, i.e., digital working tooth 150. As in this example, working plane 147 preferably may be positioned generally parallel to a section of digital working tooth 150 (in the example shown, working teeth 150 to be treated) that will become the prepared surface of the working tooth after preparation of the working tooth. In this example, working plane 147 is perpendicular to an axis defining apical-coronal directions, while in other arrangements, the working plane may be set at other orientations such as but not limited to along a mesial-distal axis. The orientation of working plane 147 sets the orientation of other settings described further herein.
[0175] As shown in FIG. 7, a depth for what will become the prepared surface of the working tooth to be treated is set by depth markers 149A, 149B within solid digital 3D model 139B. When the existing original surface of the working tooth to be treated is prepared by a cutting tool, e.g., a dental bur, a saw, a high pressure fluid jet cutter, etc., as described further herein, the depth set by depth marker 149A corresponds to a current setting for the depth that a tip or edge of the cutting tool will reach during preparation of the working tooth, and the depth set by depth marker 149B corresponds to a desired depth that the tip or the edge of the cutting tool reaches during preparation of the working tooth. Tool surrogate 148 extends in a direction of the tip of the cutting tool, e.g., a bur, intended for the preparation of the working tooth.
[0176] As shown in FIG. 8, tool path 151 is initially set within solid model building application 135A as cutting path data at a position spaced from digital working tooth 150 along a path to be followed by the cutting tool. Path 151 is preferably one that removes the minimal amount of tooth structure from the working tooth to be treated that is needed to be removed to correct for each malady or other undesirable aspect of the working tooth while also providing a sufficient surface area and appropriate form to attach a restoration. Additionally, although path 151 may be in any form within the limitations of solid model building application 135A and the cutting tool, the path is preferably in the form of a plane or a curvate shape that may be convex or concave relative to digital working tooth 150. Tool path 151 is preferably set after the depth is set by depth markers 149A, 149B, although the path may be set before or even simultaneously with the depth setting as well. As further shown by FIG. 8, while setting tool path 151 and depth markers 149A, 149B, digital working tooth 150 may be displayed with digital cuts corresponding to the currently planned cuts to be made to the working tooth.
[0177] Referring to FIG. 9, with tool path 151 initially set, the tool path may be moved closer or further away from the working tooth to be treated. Tool path 151 may also be moved generally parallel to an outer surface of digital working tooth 150, e.g. in a labial or lingual direction. As shown in FIG. 10, with tool path 151 set at a proposed position and orientation, digital prepared surface 155 of digital working tooth 150 corresponding to tool path 151 may be highlighted along edge 155A to accentuate the curvature of the digitally prepared surface corresponding to a proposed prepared surface of the patient upon removal of tooth structure from the working tooth to be treated. In this manner, the user of solid model building application 135A may validate the location of tool path 151 to confirm it is at the desired location and to generate prepared 3D model 139C including digital working tooth 150 with digital prepared surface 155. Otherwise, tool path 151 may be any one or any combination of repositioned and reoriented relative to digital working tooth 150 until the tool path is positioned to achieve the desired tooth preparation. The user of solid model building application 135A then provides an input, such as by clicking an icon on the GUI of the specialty tool package, to set the tool path upon which cutting tool path data, which corresponds to digital cutting tool surrogate 164 shown in FIG. 12 and discussed further below, is determined by the building application and stored in an object list. As in the example shown in FIG. 12, the cutting tool path data may correspond to slots to be formed in digital guide body 165 discussed further below.
[0178] Referring now to FIG. 11, once tool path 151 is determined and set where desired, the user of solid model building application 135A provides an input, such as by clicking an icon on the GUI of the specialty tool package, to instruct the building application to create initial cutting guide data corresponding to digital guide body outer shell 162 around outer surface 153 of digital working tooth 150 (See FIGS. 7 and 9). As in the example shown, solid model building application 135A is preferably configured with preset outer dimensions defined by digital shell outer surface 163 of digital guide body outer shell 162, which may be based on population sample data of the configuration of patients' mouths, that are applied to the digital guide body outer shell when formed, although such dimensions may be modified within solid model building application 135A, e.g., to address extreme variations of the configuration of the particular patient's mouth from the standard dimensions preset in the building application. As in the example shown, digital guide body outer shell 162 may also extend around digital outer surface 154 of digital neighboring tooth 152 (or digital outer surfaces 154 of digital neighboring teeth 152 as shown) of digital working tooth 150 that corresponds to the neighboring tooth of the working tooth of the patient to be treated. In this manner, a portion of digital guide body outer shell 162 may conform to digital outer surface 154 of digital neighboring tooth 152.
[0179] As illustrated by FIG. 12, the user of solid model building application 135A provides an input, such as by clicking an icon on the GUI of the specialty tool package, to instruct the building application to display digital cutting tool surrogate 164 within digital guide body outer shell 162 based on the cutting path data described above. Digital cutting tool surrogate 164 has dimensions at its extremities that correspond to the extremities of possible travel of extremities of a physical cutting tool, such as those described previously herein. The user of solid model building application 135A then provides an input, such as by clicking an icon on the GUI of the specialty tool package, to instruct the building application to apply a Boolean operation to merge digital guide body outer shell 162 and digital cutting tool surrogate 164 at their intersections. The model created by this merger corresponds to final cutting guide data. This Boolean operation is a subtractive operation such that the volume and shape of digital cutting tool surrogate 164 is subtracted from digital guide body outer shell 162 to form digital guide body 165.
[0180] Referring now to FIG. 13, a user of a building application, which may be building application 135, provides an input, such as by clicking an icon on a GUI of the specialty tool package used in preparing new digital 3D model 139A, of another specialty tool package, or otherwise in the building application, to place boundary markers 166 at the base of the digital crown of digital neighboring tooth 152 (or, as in the example shown, a plurality of neighboring teeth 152) of digital working tooth 150 and of digital working tooth 150. Boundary markers 166 establish a desired depth along a tooth wrap to be generated based on digital tooth wrap 168 shown in FIG. 14. Still referring to FIG. 14, the user of building application 135 provides an input, such as by clicking an icon on the GUI of the specialty tool package or otherwise in the building application, to instruct the building application to create initial instrument configuration data corresponding to digital tooth wrap 168 having digital inner surfaces (not shown) identical to or substantially identical to, i.e., having dimensions slightly offset from, digital outer surfaces 154 of respective digital neighboring teeth 152 as well as with bottom surfaces intersecting boundary markers 166. In this manner, the digital inner surfaces of digital tooth wrap 168 may conform to digital outer surfaces 154 of digital neighboring teeth 152. As in the example shown, building application 135 is preferably configured to form digital wrap outer surfaces 169 of digital tooth wrap 168 by providing one or more preset offsets to the digital inner surfaces, in which such offsets may be but are not limited to being based on population sample data of the configuration of patients' mouths, that are applied to digital tooth wrap 168 when formed, although such dimensions may be modified within building application 135, e.g., to address extreme variations of the configuration of the particular patient's mouth from the standard offsets in the building application.
[0181] As shown in FIG. 15, digital tooth wrap 168 is imported from building application 135 into solid model building application 135A, and the user of building application 135 then provides an input, such as by clicking an icon on the GUI of a specialty tool package within solid model building application 135A, to instruct solid model building application 135A to apply a Boolean operation to merge digital tooth wrap 168 with merged digital guide body 165 to form digital guide device 170.
[0182] Referring now to FIG. 16, the user of building application 135A may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to place digital guide device 170 onto new digital 3D model 139B to confirm the fit of the digital guide device. The finalized configuration of the digital guide device 170 corresponds to and may be stored in second client computer 130 as final instrument configuration data. Once the user is satisfied with the configuration of digital guide device 170, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to export digital guide device 170, which may be exported as a new file such as but not limited to an .STL file, to an appropriate computer-aided manufacturing (CAM) device, which may be any known appropriate subtractive manufacturing device that removes material from a block of material or any known appropriate additive (layer) manufacturing (AM) device, such as a stereolithography machine, that would build a guide device having the dimensions corresponding to the dimensions set for digital guide device 170. Physical guide devices preferably may be made of plastics such as but not limited to VisiJet M2R-TN (Dental), VisiJet M3 Crystal (MJP), VisiJet M3 Dentcast (MJP), VisiJet M3 Pearlstone (MJP), VisiJet M3 Stoneplast (MJP), VisiJet SL e-Stone (SLA), NextDent Ortho IBT, NextDent Ortho Clear, and NextDent Model Ortho, all by 3D Systems, Inc.
[0183] As further shown in FIG. 16, digital guide body 165 of digital guide device 170 generally includes digital entry portion 172 and digital slide portion 177. Digital entry portion 172 includes digital cutting tool passage 173 corresponding to physical cutting tool passage 183 of physical guide body 181 configured to receive a shaft of a cutting tool, e.g., the cutting edges of shaft 211 of dental bur 210, and digital guide entry slot 174 corresponding to physical guide entry slot 184 of physical guide body 181 configured to receive a corresponding mechanical guide of the cutting tool, e.g., guide plate 212 on dental bur 210 (see FIG. 18). Digital slide portion 177 includes digital connector opening 178 corresponding to a physical connector opening of physical guide body 181 configured to receive a connector of the cutting tool, e.g., connector 214 of dental bur 210, and allow the connector to slide within the opening as well as digital guide slide slot 175 corresponding to a physical guide slide slot of physical guide body 181 configured to receive the corresponding mechanical guide of the cutting tool. Connecting digital entry portion 172 and digital slide portion 177 is digital bridge opening 179 corresponding to physical bridge opening 189 of physical guide body 181 which, like the connector opening, is configured to receive the connector of the cutting tool (see FIG. 18).
[0184] Examples of physical guide devices having entry and slide portions fabricated from corresponding digital guide devices having corresponding digital entry and digital slide portions are shown in FIGS. 17 and 18 in their appropriate positions on working teeth within the mouth of a patient. In the example of FIG. 17, physical guide device 180A, which has been fabricated in the manner set forth above, includes a series of three physical guide bodies 181A, 181B, 181C attached together end-to-end and physical tooth wrap 188A attached to an end of one of the guide bodies. In the example of FIG. 18, dental preparation system 100 includes physical guide device 180B and dental instrument 210, which may be a cutting tool in the form of a dental bur in this example, inserted into the physical guide device. As shown, physical connector 214 connects handpiece 215, which includes a motor for rotation of shaft 211, of dental instrument 210 to guide plate 212 of the dental instrument. In this manner, a sufficient force exerted on handpiece 215 in a direction parallel to a longitudinal axis of physical guide entry slot 184 of physical guide body 181 and in a direction perpendicular to entry opening 184A, which force may be caused by a dentist holding the handpiece, moves dental instrument 210 until guide plate 212 of the dental instrument abuts the physical guide slide slot of physical guide body 181. Once guide plate 212 is so positioned in abutment with the physical guide slide slot, guide plate 212 may be slid between ends of the physical guide slide slot corresponding to opposing digital guide slide slot ends 175A (see FIG. 16; one end of digital guide slide slot now shown).
[0185] Preferably, during treatment of the working tooth to be treated, the physical guide device of the present technology, such as physical guide devices 180A, 180B, should remain fixed and not move once it is placed around the working tooth. Moreover, the physical guide device should remain in a stable position even when a dental instrument intended for use with the dental instrument, such as dental instrument 210, makes contact with it. The position of the physical guide device can be secured by contact of surfaces of the physical guide device with surfaces of teeth in a patient's mouth, preferably around the crowns of the patient's teeth, or by the use of a bonding agent, such as one that is light cured or a temporary cement or by projections from the physical guide device that engage portions of one or more teeth in the patient's mouth, including the working tooth, any adjacent teeth of the working tooth such as the neighboring teeth of the working tooth, or dentition on the jaw opposing the jaw with the working tooth.
[0186] In some alternative arrangements, in an example of a “reversal of parts,” physical guide entry slot 184 and physical guide slide slot, and accordingly digital guide entry slot 174 and digital guide slide slot 175 respectively, may be shaped in the form of guide plate 212 whereas the guide plate may be shaped in the form of the physical guide entry such that the new form of the guide plate slides within the physical guide entry slot.
[0187] With reference to FIGS. 19A and 19B showing working teeth 190A before and working teeth 190B after preparation using system 100, when guide plate 212 is slid between opposing ends of the physical guide slide slot, the cutting edges of shaft 211 of dental bur 210 remove tooth structure from the working tooth to be treated to form prepared surfaces 185 corresponding to a digital prepared surface, such as prepared surface 155, of a digital working tooth, such as digital working tooth 150. In some arrangements, a restoration (or a plurality of restorations), such as but not limited to a veneer, may be prepared to have an outer surface at least substantially corresponding to an outer surface of original working tooth 190A and to mate with prepared surface 185 of prepared working tooth 190B such that upon attachment of the restoration to the prepared surface, the combination of the prepared working tooth with the restoration is at least substantially similar to original working tooth 190A. In some arrangements, the restoration may have an outer surface that is customized but noticeably different, e.g., more cosmetically desirable to a patient, than the outer surface of original working tooth 190A. In still other arrangements, the restoration may be an “off-the-shelf” configuration in which a prepared surface of a working tooth to be treated may be formed to mate with such a restoration using a physical guide device corresponding to a digital guide device fabricated using building application 135 with the specialty tool package in which the configuration of the surface of the restoration for mating with the prepared surface of the working tooth is included as an input in preparing the digital guide device.
[0188] As shown in FIG. 20A, process 300 prepares a working tooth or working teeth to receive a restoration. At block 310, a physical model of a plurality of teeth in the mouth of a patient is scanned by a suitable scanner. At block 320 and following the step at block 310, tooth data corresponding to digital topography of the scanned physical model of the plurality of teeth is received by one or more processors of a client computer, such as second client computer 130, which may receive the tooth data from first client computer 120. At block 330 and following the step at block 320, cutting path data corresponding to a cutting path to be followed by a dental cutting tool based on the tooth data is stored by one or more processors of the client computer. At block 335 and following the step at block 320, cutting depth data corresponding to a cutting depth to be reached by the cutting tool based on the tooth data is stored by one or more processors of the client computer. The steps at blocks 330 and 335 may be performed in any order, including simultaneously. At block 340 and following the step at block 320, initial cutting guide data corresponding to a cutting guide shell structure for placement around a portion of a tooth to be treated and based on the tooth data is determined by one or more processors of the client computer. At block 350 and following the steps at blocks 330 and 335, cutting tool path data corresponding to preset limits on tool movements to be made by the cutting tool is determined by one or more processors of the client computer based on the cutting path data and the cutting depth data. At block 360 and following the steps at blocks 340 and 350, a first Boolean operation between the initial cutting guide data and the cutting tool path data is performed by one or more processors of the client computer to define final cutting guide data corresponding to final cutting guide structure for guiding the cutting tool. At block 370 and following the step at block 360, a second Boolean operation is performed between the final cutting guide data and initial instrument configuration data corresponding to a fixation instrument configuration for fixing dental instrumentation, which is for use in guarding the cutting tool to remove tooth structure from the tooth to be treated, to an adjacent tooth to the tooth to be treated. In this manner, final instrument configuration data corresponding to the final instrument configuration for releasably fixing the dental instrumentation to the adjacent tooth and for guiding the cutting tool in the removal of the tooth structure for the tooth to be treated is defined. At block 380 and following the step at block 370, the final instrument configuration data is exported to a data storage file configured for use with an AM or CAM device. At block 390 and following the step at block 380, the final instrument configuration is fabricated using an appropriate CAM or AM device.
[0189] Referring now to FIG. 20B, process 900 prepares a working tooth or working teeth to receive a restoration. Prior to block 905, process 900 includes the step at blocks 310 and 320 of process 300. At block 905, patient biometric data which may include a the sex and age of a patient, optionally may be stored by one or more processors of the client computer, which for purposes of process 900 refers to being stored on the client computer or stored on a server or other memory storage medium in communication with the client computer. At block 910 which may be before, after, or simultaneously with the step at block 905, patient morphological data corresponding to shape and dimensional characteristics of at least a portion of the dentition of the patient are stored by one or more processors of the client computer. At block 915 which may be before, preferably after, or simultaneously with the steps at blocks 905 and 910, a selection of a style template from a plurality of style templates corresponding to one or more tooth shape factors to be applied to the final tooth configuration computer-aided design (CAD) model optionally may be stored by one or more processors of the client computer. This selection may be made through use of filter boxes in which the user of the client computer might select from a list of general sizes, e.g., small, medium, or large, and from a list of general shapes, e.g., trapezoidal form, for the general nature of a final tooth configuration to be prepared. At block 920, tooth margin data corresponding to a tooth margin to remain on the one or more working teeth following the use of the cutting tool with the tooth preparation guide on the one or more working teeth optionally and preferably may be determined and stored by the one or more processors of the client computer. A most apical portion of the tooth margin may correspond to the finish line of a dental restoration, e.g., crown, bridge, veneer, etc., to be placed on a working tooth. In one example, the tooth margin data may be automatically determined upon upload of patient scan data to the client computer.
[0190] At block 930 and following the steps at blocks 905-920, a tooth configuration CAD model based on any one or any combination of the patient biometric data, the patient morphological data, the tooth margin data, the selected style template, and past final tooth configuration data corresponding to past final tooth configuration CAD models is proposed as a tooth configuration CAD model by the client computer to the user. In particular, the tooth configuration CAD model is displayed, e.g., on a computer monitor, to the user for review and analysis. The past final tooth configuration data corresponds to and is a digital form of a past final tooth configuration CAD model. The past tooth configuration data may be stored by the one or more processors of the client computer and may be utilized as final tooth configuration data where a combination of the other inputs, e.g., the patient biometric data, the patient morphological data, the tooth margin data, and the selected style template, are within a preset range of inputs associated with and recorded in digital form within past final tooth configuration data associated with a past patient. If the user is satisfied with, i.e., approves of, the proposed tooth configuration CAD model, the proposed tooth configuration CAD model is stored by the one or more processors of the client computer as final tooth configuration data corresponding to the final tooth configuration CAD model and thus to a final tooth configuration following the use of the cutting tool with the tooth preparation guide on the one or more working teeth and receipt of the one or more tooth restorations on the one or more prepared working teeth.
[0191] If the user of the client computer desires to modify the proposed tooth configuration CAD model, at block 935, the proposed tooth configuration CAD model is modified at the direction of the user to the client computer by adding, subtracting, or smoothing a portion of the proposed tooth configuration CAD model until the user is satisfied with the tooth configuration CAD model. The approved tooth configuration CAD model is then stored by the one or more processors of the client computer as the final tooth configuration data corresponding to the final tooth configuration CAD model and thus to a final tooth configuration. The final tooth configuration CAD model defines an outer, i.e., buccal or labial, surface of the portion of the dentition of the patient under consideration and thus an outer surface of an eventual restoration to be prepared as described further herein.
[0192] At block 940, the one or more working teeth to be prepared by the use of the cutting tool with the tooth preparation guide are identified by the one or more processors of the client computer based on differences between the patient morphological data and the final tooth configuration data. At block 945, default wall thickness data is set by the one or more processors of the client computer based on the final tooth configuration CAD model in which the wall thickness data corresponds to a wall thickness or set of wall thicknesses of a restoration to be prepared as described further herein. At block 950, tooth reduction data based on the patient morphological data and the final tooth configuration data is determined and stored by the one or more processors of the client computer. The tooth reduction data corresponds to tooth structure to be removed from the one or more working teeth to prepare the one or more working teeth to receive the respective one or more tooth restorations is proposed by the one or more processors of the client computer. In this manner, an inner, i.e., lingual, surface of the eventual restoration which will abut the prepared outer surface of a working tooth is defined by removing the wall thickness from the final tooth configuration, i.e., as being the set of points that are at a set wall thickness away in a lingual direction from a corresponding point of the final tooth configuration.
[0193] The tooth reduction data may correspond to a tooth reduction CAD model that may be superimposed on a CAD model of the dentition of the patient to be treated and displayed on a display monitor associated with the client computer. In this manner, a user of the client computer may visualize the tooth structure planned for removal based on the tooth reduction data. In some arrangements, the tooth reduction CAD model may be shown with color mapping that may identify areas in which the tooth structure to be removed is within a first range in first color, e.g., blue for a range of tooth structure removal that is relatively high, areas in which the tooth structure to be removed is within a second range in a second color, e.g., purple for a range of tooth structure removal that is relatively medium, areas in which the tooth structure to be removed is within a third range in a third color, e.g., red for a range of tooth structure removal that is relatively low, and so on.
[0194] At block 960, tooth preparation guide data based on the tooth reduction data, cutting tool thickness data corresponding to a thickness of the cutting tool to be used in removing the tooth structure from the one or more working teeth, and preparation guide offset data corresponding to a thickness of the tooth preparation guide to be fabricated is prepared and stored by the one or more processors of the client computer. The prepared tooth preparation guide data may be visualized on a display monitor associated with the client computer as a tooth preparation guide CAD model. If the user of the client computer is approves of the tooth preparation guide CAD model, then the prepared tooth preparation guide data becomes final tooth preparation guide data that is stored by the one or more processors of the client computer and the process 900 proceeds to directly to block 970. If the user of the client computer desires to adjust the tooth preparation guide CAD model, at block 965, the tooth preparation guide CAD model is adjusted at the direction of the user to the client computer to define adjusted tooth preparation guide data. In some arrangements, the tooth preparation guide data may be adjusted by adjusting via the one or more processors of the client computer at least a portion of the preparation guide offset data in which the adjusted portion of the preparation guide offset data corresponds to one or more thicknesses at corresponding portions of the tooth preparation guide to be fabricated. In some arrangements, the tooth preparation guide data may be adjusted by adjusting via the one or more processors of the client computer guiding surface data corresponding to a guiding surface of the tooth preparation guide configured for contacting the cutting tool to limit the movement of the cutting tool in removing the tooth structure from the one or more working teeth. One or both of these example adjustments may be made to the tooth preparation guide data.
[0195] At block 970 and following the step at block 960 or the step at block 965 depending on whether adjustments are made, the approved tooth preparation guide data is exported to a data storage file configured for use with an AM or CAM device. At block 975 and following the step at block 970, a tooth preparation guide corresponding to the approved tooth preparation guide data is fabricated using an appropriate CAM or AM device. A dental overlay device for placing veneers may then be prepared as described further herein using the final tooth configuration data and the tooth reduction data or wall thickness data.
[0196] Referring now to FIGS. 20C-20I, in an alternative arrangement, a tool path for a cutting tool may be generated in a different manner than described previously herein with respect to tool path 151 (see FIG. 9), in particular without the need to define multiple planes. With reference to FIG. 20C, a point is placed adjacent to working tooth 1105 on a working tooth model with a CAD software package in accordance with an embodiment. In this example, the point is dragged from right to left across the gum model to create segment 1107 at a location on or near the gumline of working tooth 1105. If satisfactory, created segment 1107 is approved to set a plane extending generally below working tooth 1105.
[0197] As shown in FIG. 20D, points are applied within the set plane and along a linear or curvilinear axis to adjacent to working tooth 1105 to create spline 1110. With reference to FIG. 20E, once spline 1110 is approved, cutting path 1151 is automatically generated by the CAD software. Cutting path 1151 extends along spline 1110 and extends vertically, i.e., in the apical direction, from the plane defined by segment 1107. Cutting path 1151 defines a cutting envelope for a cutting tool corresponding to cutting tool model 1199 further shown in FIG. 20E. The cutting envelope may be adjusted by modifying parameters associated with cutting tool model 1199. In some arrangements, a selection of pre-installed options of cutting tool models 1199 having different dimensions and corresponding to a cutting tool having different diameters or lengths may be provided such that a user may select a desired cutting tool model 1199, e.g., from a dropdown box provided within the CAD software, from the set of options of cutting tool models.
[0198] As shown in FIG. 20F, control points of spline 1110 may be modified to spline 1110A to modify cutting path 1151 to cutting path 1151A accordingly. As shown in FIG. 20G, spline 1110, 1110A may be further modified by dragging spline handles 1111 (shown as darker segments), although spline segments 1112 (shown as lighter segments) must remain in position in this state.
[0199] As shown in FIG. 20H, a CAD model of tooth structure to be removed by the set cutting path 1151/1151A may be viewed in a cross-sectional view showing the extent of material to be removed if the tooth structure corresponding to the cutting path were to be removed. As shown in FIG. 20I, cutting tool model 1199 may be shown within the CAD model to model an orientation of entry of a corresponding cutting tool within an entryway into a cutting guide produced with cutting surfaces corresponding to cutting path 1151/1151A. Other than the differences described above with respect to FIGS. 20C-20I, a cutting guide may be prepared using tool path 1151/1151A as to remaining processes to fabrication in the same manner as physical guide device 180A may be produced, e.g., the manner of fabrication described with respect to the final instrument configuration fabricated at block 390.
[0200] Part 2: Digital Preparation of Placement Guide Devices for Placing a Restoration.
[0201] Advantageously, in conjunction with the preparation of a digital guide device, such as the digital guide device 170 described previously herein, and accordingly a physical guide device corresponding to the digital guide device, a placement guide device for applying a restoration, such as but not limited to a placement tray for applying a veneer, to the working teeth within a patient's mouth may be prepared. As noted above, in some arrangements, a corresponding restoration, such as a set of veneers also may be prepared. Referring now to FIGS. 21 and 22, a prepared 3D model, such as prepared 3D model 139C, including a digital working tooth with a digital prepared surface, such as digital working tooth 150 with digital prepared surface 155 for example or the set of digital working teeth 250 with respective digitally prepared surfaces as shown, and a digital model of the restoration or restorations, such as digital restorations 295 as shown, to be applied to the respective tooth or teeth of the patient may be merged and imported into building application 135 with the specialty tool package as restored tooth data. In this manner, as shown in FIG. 22, restored 3D model 400, which corresponds to the restored tooth data and as shown may be a digital clay model, of the patient's teeth corresponding to the desired form of the patient's teeth, through the use of the restoration or restorations, may be generated in preparation for modeling a placement guide device, i.e., retention splint, to appropriately place the restoration or restorations in a patient's mouth.
[0202] Referring now to FIGS. 23A and 23B, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to perform a block out on the restored 3D model to detect the undercut areas of digital working teeth 250 and to establish an insertion path (and, in some instances, setting within the building application an insertion axis) for a model placement guide device in order to remove undercuts from the restored 3D model and thus form modified restored 3D model 400A. As in this example, building application 135 with the specialty tool package removes such undercuts automatically based on the designation of the insertion axis. In this manner, restored 3D model 400A includes surfaces that may be used to conform a model placement guide device corresponding to a physical placement guide device that may be passively placed over and fitted onto a patient's teeth without exerting any pressure or at least any significant amount of pressure. Once restored 3D model 400A is finalized as desired, as shown in FIGS. 24A-24C, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to covert restored 3D model 400A from a clay model to buck, i.e., blocked out, model 400B.
[0203] With reference to FIGS. 25A and 25B, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a design tool in order to draw boundary 402, i.e., an extreme edge or extreme edges, corresponding to initial primary support configuration data for the digital occlusal surface support, i.e., digital primary support discussed further herein, for the placement tray to be fabricated. As in the example, such boundaries may be but are not limited to being drawn sufficiently around digital support teeth 452, which as shown may be opposing digital molars, such that building application 135 with the specialty tool package understands the boundaries to be intended to be closed boundaries. In this manner, portions of the placement tray to be fabricated that will be placed over teeth not requiring restoration and that may provide the most stabilization and positioning of the fabricated placement tray are digitally defined.
[0204] As shown in FIG. 26, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a design tool in order to draw a sufficiently closed boundary 404 corresponding to initial lingual support configuration data for the digital lingual or palatal body support, i.e. digital lingual auxiliary support, for the placement guide device to be fabricated. As in this example, such a boundary may be but is not limited to being drawn sufficiently around the digital lingual side of digital working teeth 450 and preferably down to or near the set of digital gumlines 405. In this manner, portions of the fabricated placement guide device intended to contact the working teeth requiring restoration, and in some instances adjacent teeth of those working teeth that may not be in need of a restoration, are digitally defined. As shown, sufficiently closed boundaries 402 and 404 may intersect with each other.
[0205] Referring now to FIG. 27A, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a design tool in order to identify the region within boundary 402 around digital support teeth 452 to be embossed, i.e. thickened away from the digital support teeth. As shown in FIG. 27B, building application 135 with the specialty tool package, upon receiving an input from the user, then embosses the region within boundary 402 and away from digital support teeth 452 by adding digital clay within the boundary as well as adding digital clay, by a predetermined distance, in a direction away from the boundary to form digital primary support 460 corresponding to final primary support configuration data.
[0206] As illustrated in FIG. 28, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select the embossing design tool in order to identify the region within boundary 404 around the digital lingual side of digital working teeth 450 to be embossed. As shown in FIG. 29, building application 135 with the specialty tool package is then used to emboss the region within boundary 404 and away from digital working teeth 450 by adding digital clay within the boundary as well as, by a predetermined distance, in a direction away from the boundary to form digital lingual auxiliary support 462 corresponding to final lingual support configuration data.
[0207] Still referring to FIG. 29, as in this example, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a drawing tool to add digital clay between digital primary support 460 and digital lingual auxiliary support 462 to connect and form digital intersection 466 (shown in FIG. 30) corresponding to lingual connecting support configuration data between these supports. With reference to FIG. 30, the digital surfaces of any one or any combination of digital primary support 460, digital lingual auxiliary support 462, and digital intersection 466 are smoothened as needed. In this manner, potential rough edges that may otherwise be formed during eventual fabrication of the physical placement guide device are reduced or eliminated, and potential patient discomfort due to such edges is accordingly reduced or eliminated.
[0208] Referring now to FIGS. 31A and 31B, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a design tool in order to draw a sufficiently closed boundary 406 corresponding to initial buccal support configuration data for the digital buccal or labial support, i.e., digital buccal auxiliary support, for the placement guide device to be fabricated. As in this example, such a boundary may be but is not limited to being drawn sufficiently around a portion of the digital buccal side of digital working teeth 450 and preferably over an approximately central region of the digital working teeth. In this manner, portions of the fabricated placement guide device that will contact the one or more restorations are digitally defined. As shown, sufficiently closed boundaries 402 and 406 may be near or intersect with each other.
[0209] With reference to FIG. 32, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select the embossing design tool in order to identify the region within boundary 406 around the digital buccal side of digital working teeth 450 to be embossed. As shown, building application 135 with the specialty tool package is used to emboss the region within boundary 406 and away from digital working teeth 450 by adding digital clay within the boundary as well as, by a predetermined distance, in a direction away from the boundary to form digital buccal auxiliary support 464 corresponding to final buccal support configuration data.
[0210] Referring now to FIG. 33A, as in this example, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a drawing tool to add digital clay between digital primary support 460 and digital buccal auxiliary support 464 to connect and form digital intersection 467 corresponding to buccal connecting support configuration data between these supports. With reference to FIG. 33B, the digital surfaces of any one or any combination of digital primary support 460, digital buccal auxiliary support 464, and digital intersection 467 are smoothened as needed. In this manner, potential rough edges that may otherwise be formed during eventual fabrication of the physical placement guide device are reduced or eliminated, and potential patient discomfort due to such edges is accordingly reduced or eliminated.
[0211] Referring to FIGS. 34A and 34B, the user of building application 135 with the specialty tool package may provide inputs to the building application to prepare, in the same manner digital primary support 460, digital lingual auxiliary support 462, and digital buccal auxiliary support 464 are prepared, occlusal connector configuration data corresponding to one or more digital connector supports 465 configured for contacting the one or more digital restorations, and preferably as in this example configured for wrapping around the digital restorations, to support the digital restorations. Digital connector supports 465 extend between, and initially or with the use of additional digital clay intersect with digital lingual auxiliary support 462 and digital buccal auxiliary support 464. In this manner, when the physical placement guide device is formed, connector supports corresponding to digital connector supports 465 support the restorations corresponding to the digital restorations. As further shown, digital connector supports 465 are spaced apart along digital working teeth 450 of restored 3D model 400B. In this manner, physical connector supports corresponding to digital connector supports 465 may provide support for the restorations corresponding to the digital restorations and may provide visibility of the teeth corresponding to digital working teeth 450. As such, the physical connector supports may allow for flossing of or otherwise cleaning, such as of excess adhesive, in between restorations, e.g., veneers, corresponding to the digital restorations, and in particular after tag curing, i.e., partially curing, such as by light exposure, the restorations to the working teeth. Furthermore, physical connector supports corresponding to digital connector supports 465 allow for excess flowable luting cement, e.g., a photosensitive curable cement, used for placing the physical restorations to flow between the connector supports. In this manner, the excess cement may be removed by a dentist, e.g., using brushes, prior to its curing while the cement is in the liquid stage and thus more easily removable. Digital surfaces of any one or any combination of digital connector supports 465, digital lingual auxiliary support 462, and digital buccal auxiliary support 464 are smoothened as needed to generate initial retention splint data corresponding to rough digital placement guide device 468.
[0212] Referring to FIG. 35, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a tool to dive, i.e., separate, rough digital placement guide device 468 from restored 3D model 400B, i.e., in this example, to separate the clay mesh model from the buck model. With reference to FIG. 36, the user of building application 135 may provide an input, such as by clicking an icon on the GUI of the specialty tool package, to select a tool to remove undesired portions, i.e. to “clean,” rough digital placement tray 468, thus generating final retention splint data corresponding to final digital placement guide device 470, which may be a final digital placement tray as shown in FIG. 37.
[0213] With reference to FIGS. 37 and 38, the file size of final digital placement guide device 470 is reduced and the reduced file is converted and electronically stored as an .STL file or other compatible file for use with a CAM or AM device, such as on second client computer 130 or network 140 of system 105. With reference to FIG. 39, in some arrangements, the stored .STL file corresponding to final digital placement guide device 470 is processed in an AM device, which may be a 3D printer in the MP series by 3D Systems, Inc., to form a corresponding physical placement guide device.
[0214] Physical placement guide devices, such as placement trays, formed by way of the process described previously herein may take but are not limited to taking the form of any of the physical placement trays shown in FIGS. 40A-40C. Physical placement tray 510 includes primary supports 512 corresponding to digital primary supports, lingual auxiliary support 514 attached to and extending between the primary supports as well as corresponding to a digital lingual auxiliary support, buccal auxiliary support 516 attached to and extending between the primary supports as well as corresponding to a digital buccal auxiliary support, and spaced apart connector supports 518 attached to and extending between the lingual and buccal auxiliary supports corresponding to digital connector supports. Physical placement tray 610 is substantially similar to physical placement tray 510 with the notable exception that some of the connector supports, in this example connector supports closer to digital primary supports, of physical placement tray 610 are only attached to a buccal auxiliary support of physical placement tray 610. In this manner, physical placement tray 610 has some obstructed openings in contrast to physical placement tray 510. The connector supports of physical placement trays 510, 610, such as connector supports 518, provide support for restorations, e.g., veneers, and provide visibility of the teeth to which they are fitted. In this manner, such physical connector supports allow for the possibility to floss in between the restorations after tag curing the restorations to the working teeth. Furthermore, such physical connector supports allow for excess flowable luting cement to flow between the connector supports such that the cement may be removed by a dentist as discussed above.
[0215] As shown in FIG. 40C, physical placement tray 710 includes primary supports 712 corresponding to digital primary supports as well as a combination of a lingual auxiliary support corresponding to a digital lingual auxiliary support, a buccal auxiliary support corresponding to a digital buccal auxiliary support, and connector supports corresponding to digital connector supports that together define holes 720 through the physical placement tray. The connector supports of physical placement tray 710 allow for adhesive for placing restorations in placement tray 710 and for partially cured cement adhering the restorations to the working teeth to pass through the holes during fixation of such restorations. As further shown, holes 720 may be prepared such that sets of between two and six holes of physical placement tray 710 correspond to each working teeth of a patient to be treated.
[0216] With reference to FIG. 41, in some arrangements, a dentist or preferably a technician in a dental laboratory sets restorations, e.g., veneers, on a physical model of a plurality of teeth of a patient to be treated and then applies temporary photosensitive adhesive 498 to an inner region of a physical placement tray intended for receipt of restorations. The physical placement tray is then properly placed onto the restorations and the physical model such that the restorations are seated into fitted grooves of the placement tray corresponding to the restorations. In some instances, the restorations may be depressed against adhesive 498 to more firmly attach the restorations to the placement tray. The combination of the placement tray and the restorations seated in and fixed to the tray are then removed from the physical model.
[0217] With reference to FIGS. 42A and 42B, a dentist applies dental cement or a permanent (strong) adhesive to a prepared surface of working teeth of a patient, or to a lingual side of restorations to be placed in the mouth of the patient, and subsequently applies the physical placement tray with the adhered restorations over the working teeth such that the appropriate grooves of the physical placement tray align with the corresponding working teeth and such that the restorations adhered to the corresponding teeth of the patient. The adhesive between the restorations and the teeth is then tag cured, generally in the cervical region of the teeth, and the excess adhesive is removed as much as possible through and around the placement tray while the adhesive is more easily movable. The adhesive is then fully cured, e.g., via light, and then the placement tray is separated from the mounted restorations and removed from the mouth of the patient. An example of the difference in the cosmetic look of a patient before placement of a restoration and after such placement is provided in FIGS. 43A and 43B.
[0218] Referring now to FIGS. 40D and 40E, physical placement tray 1010 is a dental overlay device that includes wrap portions 1012, base 1013, a plurality of struts 1018, and a plurality of tooth receptacles 1019. Wrap portions 1012, which in the example shown are respectively configured to extend around the first molars of the patient, include inner surfaces that conform to the shape and dimensions of a plurality of teeth in the mouth of a patient such that when the wrap portions of tray 1010 are placed onto the corresponding teeth of the patient. Base 1013 extends between wrap portions 1012 such that the base has a shape generally in the form of the patient's dental arch. When properly placed in the mouth of the patient, base 1013 extends behind the teeth of the patient. As shown in FIG. 40A, each of the plurality of struts 1018 attach to base 1013 at one end of the respective strut, extend in a generally orthogonal direction away from the base, and attach to an opposing end of a respective one of the plurality of tooth receptacles 1019. As shown in FIG. 40B, each of the plurality of tooth receptacles 1019 are prepared to surround a corresponding tooth of the patient and a veneer for placement onto such tooth. As further shown, each tooth receptacle 1019 includes holes 1020 that operate in the same manner as holes 720 of placement tray 710 described above. As shown in FIG. 40A, each tooth receptacle 1019 extends generally parallel to base 1013 so as to align a veneer placed into the tooth receptacle with the corresponding tooth of the patient.
[0219] In use, placement tray 1010 operates in a substantial similar manner to that of placement trays 510, 610, 710. However, as best shown in FIG. 40A, each of the plurality of receptacles 1019 are spaced from adjacent receptacles such that floss may be passed between adjacent receptacles and thus between corresponding teeth during a veneer placement procedure to remove excess cement between the receptacles and between the teeth within such receptacles prior to a final light cure of the cement while placement tray 1010 is in place. In this manner, the need to use a saw to remove cement between the teeth after removal of the placement tray is reduced or eliminated.
[0220] As shown in FIG. 44, process 800 prepares a physical placement tray to receive a restoration and sets the physical placement tray over working teeth of a patient using the placement tray. In some arrangements, process 800 may follow process 300. At block 810 of process 800, a 3D CAD model of unrestored and restored teeth combining a tooth to be treated and a restoration applied to the tooth to be treated is merged via one or more processors of a client computer, such as second client computer 130, to create restored tooth data. At block 820 and following the step at block 810, initial primary support configuration data corresponding to a digital model outline of instrument fixation support structure based on restored tooth data is stored by one or more processors of the client computer. At block 830 and following the step at block 810, initial lingual support configuration data corresponding to a digital model outline of instrument lingual support structure based on the restored tooth data is stored by one or more processors of the client computer. At block 840 and following the step at block 810, initial buccal support configuration data corresponding to a digital model outline of instrument buccal support structure is stored by one or more processors of the client computer. The steps at blocks 820, 830, and 840 may be performed in any order including simultaneously. At block 825 and following the step at block 820, final primary support configuration data corresponding to the instrument fixation support structure is stored by one or more processors of the client computer. At block 835 and following the step at block 830, final lingual support configuration data corresponding to the instrument lingual support structure is stored by one or more processors of the client computer. At block 845 and following the step at block 840, final buccal support configuration data corresponding to the instrument buccal support structure is stored by one or more processors of the client computer. At block 850 and following the steps at blocks 835 and 845, occlusal connector configuration data corresponding to occlusal surface connectors attached to both the instrument lingual support structure and the instrument buccal support structure is stored by one or more processors of the client computer. At block 860 and following the step at block 850, the final primary support configuration data, the final lingual support configuration data, the final buccal support configuration data, and the occlusal connector configuration data is combined by one or more processors of the client computer to define initial retention splint data corresponding to a rough retention splint configuration. In some arrangements, at block 870A and following the steps at blocks 825 and 835, lingual connecting support configuration data corresponding to lingual connecting support structure connecting the instrument fixation support structure to the instrument lingual support structure is stored by one or more processors of the client computer. In some arrangements, at block 880A and following the steps at blocks 825 and 845, buccal connecting support configuration data corresponding to buccal connecting support structure connecting the instrument fixation support structure to the instrument buccal support structure is stored by one or more processors of the client computer. At block 860A and following the steps at block 850 and the steps at either or both of blocks 870A and 880A, the final primary support configuration data, the final lingual support configuration data, the final buccal support configuration data, the occlusal connector configuration data, and either or both of the lingual connecting support configuration data and the buccal connecting support configuration data, as appropriate, is combined by one or more processors of the client computer to define initial retention splint data corresponding to a rough retention splint configuration. At block 890 and following the steps at either of blocks 860 and 860A as appropriate, the initial retention splint data may be separated from the restored tooth data to form final retention splint data corresponding to a final retention splint configuration. At block 895 and following the step at block 890, the final retention splint data may be exported by one or more processors of the client computer to a data storage file configured for use with a CAM or AM device. At block 899 and following the step at block 895, a retention splint, for example any one of physical placement trays 510, 610, 710, may be fabricated on a CAM or AM device based on the data storage file.
[0221] Based on aforementioned information, this technology provides for producing a restoration part, in advance of the physical revision of the tooth so that the restoration part is available to the dentist even before he or she starts physically preparing the tooth. The tooth can then be prepared with precision by using the configured overlay to revise the tooth in a manner to correspond to or mate with the interior of the restoration. The availability of the restoration makes it possible to mount it directly onto the tooth in the same visit that the tooth is prepared. This substantially reduces the inconvenience of the patient and reduces the number of visits made to the dentist. This also reduces the possibility of a prepared tooth becoming contaminated during the extended time period between tooth preparation and installation of the final restoration.
[0222] It is to be understood that the disclosure set forth herein includes all possible combinations of the particular features set forth above, whether specifically disclosed herein or not. For example, where a particular feature is disclosed in the context of a particular aspect, arrangement, configuration, or embodiment, that feature can also be used, to the extent possible, in combination with and/or in the context of other particular aspects, arrangements, configurations, and embodiments of the invention, and in the invention generally.
[0223] Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.
