DEVICE AND METHOD FOR MEASURING A MOVEMENT OF A MANDIBLE
20190076226 ยท 2019-03-14
Inventors
Cpc classification
A61C9/0053
HUMAN NECESSITIES
A61C19/045
HUMAN NECESSITIES
International classification
A61C19/045
HUMAN NECESSITIES
A61B5/00
HUMAN NECESSITIES
A61C9/00
HUMAN NECESSITIES
Abstract
The invention relates to a device (1) for measuring a relative position and/or movement of a mandible (UK) relative to a maxilla of a patient, comprising an emitting coil (8) for emitting an electromagnetic measuring field (5), at least one mandible sensor (US1), said mandible sensor (US1) being placed and/or can be placed on teeth in the mouth (U1-U8) or in the mouth on a mandible device (UK). The mandible sensor (US1) is designed as a sensor at least for determining a position in a measuring field (5) and/or relative to the emitting coil (8), also comprising an evaluation device (3) for determining the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK) based on positions determined by the sensor (US1). The sensor coil (8) is placed and/or can be placed outside of the mouth on the side or above the maxilla (OK). The invention also relates to a method for determining a relative position and/or movement of the mandible (UK) relative to a maxilla (OK) of a patient with a device (1), a device (X) for simulating and transferring a measured relative movement from the method and a holding device for at least one maxilla sensor (OS1) and/or at least one mandible sensor (US1).
Claims
1. A device (1) for measuring a relative position and/or relative movement of a mandible (UK) relative to a maxilla (OK) of a patient, comprising a transmitter coil (8) for emitting an electromagnetic measurement field (5), comprising at least one mandible sensor (US1), wherein the mandible sensor (US1) is arranged and/or arrangeable intraorally on the teeth (U1-U8) or intraorally on a mandible accessory of the mandible (UK), wherein the mandible sensor (US1) are designed as a sensor at least for determining a position in the measurement field (5) and/or in relation to the transmitter coil (8), comprising an analysis unit (3) for determining the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK) on the basis of the positions determined by the sensor (US1), characterized in that the transmitter coil (8) is arranged and/or arrangeable extraorally laterally to or above the maxilla (OK).
2. The device as claimed in claim 1, characterized by at least one maxilla sensor (OS1), wherein the maxilla sensor (OS1) is arranged and/or arrangeable intraorally on the teeth (O1-O8) or intraorally on a maxilla accessory of the maxilla (OK),
3. The device as claimed in claim 1 or 2, characterized in that the maxilla accessory of the maxilla (OK) and the mandible accessory of the mandible (UK) are respectively designed as a bite plate for setting a vertical position (condyle position).
4. The device as claimed in claim 2 or 3, characterized in that a bite plate is arrangeable on the maxilla jaw and/or a bite plate is arranged on the mandible.
5. The device as claimed in any one of claims 2 to 4, characterized in that the respective bite plate is U-shaped.
6. The device as claimed in any one of claims 2 to 5, characterized in that the respective bite plate has a centrally arranged pin or multiple pins.
7. The device as claimed in claim 6, characterized in that at least the pin has a ball having a threaded borehole, in which the pin is arranged such that it is at least vertically adjustable.
8. The device as claimed in claim 7, characterized in that the ball is held by jaws on the respective bite plate and is movable in an articulated manner.
9. The device as claimed in either one of claims 7 and 8, characterized in that the ball is held by jaws on the respective bite plate and is movable in an articulated manner.
10. The device as claimed in any one of claims 7 to 9, characterized in that the ball is lockable by a screw element.
11. The device as claimed in claim 1, characterized in that the transmitter coil is arranged above or laterally diagonally in relation to the patient and/or to a measurement space, in which the patient is positioned.
12. The device (1) as claimed in claim 1 or 2, characterized in that at least one, several, or all of the sensors (OS1, US1) each determine at least two rotational degrees of freedom, preferably all three rotational degrees of freedom, or six degrees of freedom in the measurement field (5) and/or relative to the transmitter coil (8).
13. The device (1) as claimed in any one of the preceding claims, characterized in that precisely two five DOF sensors or alternatively precisely one six DOF sensor are arranged on the maxilla and precisely two five DOF sensors or alternatively precisely one six DOF sensor are arranged on the mandible.
14. The device (1) as claimed in any one of the preceding claims, characterized in that the smallest distance between the sensor (OS1, US1) and the respective tooth is less than 0.5 cm.
15. The device (1) as claimed in any one of the preceding claims, characterized by holding units, wherein the holding units are fastened on the maxilla (OK) and/or the mandible (UK) and accommodate the sensors (OS1, US1).
16. The device (1) as claimed in any one of the preceding claims, characterized in that the respective holding units on the maxilla (OK) and/or the mandible (UK) are designed as a sensor shoe, which can be adhesively bonded on the respective teeth.
17. The device (1) as claimed in any one of the preceding claims, characterized by a digitizing unit (9, 10) for creating a digital, three-dimensional model of the maxilla (OK) and/or the mandible (UK), wherein the holding units and/or sensors (OS1, US1) are modeled in the model.
18. The device (1) as claimed in claim 17, characterized in that the digitizing unit (9, 10) is designed as an intraoral scanner (9) or as an intraoral camera.
19. A method for determining a relative position and/or relative movement of a mandible (UK) relative to a maxilla (OK) of a patient using a device (1) as claimed in any one of the preceding devices, comprising the following steps: arranging the sensors (OS1, US1) on the maxilla (OK) and on the mandible (UK); recording sensor signals of the sensors (OS1, US1), determining a relative position and/or relative movement between the maxilla (OK) and the mandible (UK) on the basis of the sensor signals.
20. The method as claimed in claim 19, comprising the following step: creating a digital, three-dimensional model of the maxilla (OK) and/or the mandible (UK), wherein the holding units and/or sensors are modeled in the model, and fusing the three-dimensional model with the determined relative position and/or relative movement to generate an image of the movement sequence.
21. The method as claimed in claim 20, characterized in that the movement sequence comprises multiple complex individual movement sequences such as opening, closing, chewing, etc.
22. A device (X) for simulating and transferring a measured relative movement from the method as claimed in any one of claims 19-21, of a mandible (UK) relative to a maxilla (OK) of a patient, comprising a receiver for receiving a digital, three-dimensional model of the maxilla (OK) and/or the mandible (UK), wherein the holding units and/or sensors for receiving data are positioned in the model,
23. A holding unit for at least one maxilla sensor (OS1) and/or at least one mandible sensor (US1), in particular for use in a device (1) as claimed in claims 1 to 18 for measuring a relative position and/or relative movement of a mandible (UK) relative to a maxilla (OK) of a patient, wherein the holding unit is fastenable on the maxilla (OK) and/or on the mandible (UK).
24. The holding unit as claimed in claim 23, characterized in that the holding unit is designed as a sensor shoe, which can be adhesively bonded on the respective teeth or a mandible accessory of the mandible (UK) or a maxilla accessory of the maxilla (OK).
25. The holding unit as claimed in claim 23 or 24, characterized in that the sensor shoe has at least one curved surface region and/or at least one position marking.
26. The holding unit as claimed in claim 25, characterized in that the position marking is formed as an indentation or recess in the curved surface region of the sensor shoe facing away from the respective tooth.
27. The holding unit as claimed in either one of claims 25 to 26, characterized in that the position marking is formed as a conical recess, the tip of which defines a zero point of the relationship of the sensor to the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK).
28. The holding unit as claimed in any one of claims 25 to 27, characterized in that the tip of the position marking has a direct relationship to a planar surface region around the recess of the sensor shoe, wherein the sensor position is defined in relation to the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK).
29. The holding unit as claimed in any one of claims 25 to 28, characterized in that the position marking is arranged centrally on the sensor shoe.
30. The holding unit as claimed in any one of claims 24 to 29, characterized in that the sensor shoe has at least one curved surface region facing toward the respective tooth or teeth.
31. The holding unit as claimed in any one of claims 24 to 30, characterized in that the sensor shoe is designed for the interlocking accommodation of a maxilla sensor (OS1) and/or a mandible sensor (US1).
Description
[0047] Further features, advantages and effects of the invention result from the following description of a preferred exemplary embodiment of the invention and the appended figures, in which:
[0048]
[0049]
[0050]
[0051]
[0052]
[0053]
[0054]
[0055]
[0056] A sensor OS1 is arranged on the maxilla OK. Optionally, still further sensors can be provided. The maxilla sensor OS1 is fastened on one or both premolars O4 and/or O5. In a similar manner, a mandible sensor US1 is arranged on the mandible UK. The mandible sensor US 1 is arranged on the premolars U4 and/or U5. Optionally, further sensors can be provided on the maxilla and/or on the mandible.
[0057] As may be inferred from the top view, the sensors OS1 or US1 are arranged directly at the respective teeth O4 or U4, respectively. The distance between the sensors and the teeth is less than 0.5 cm in each case. In particular, the sensors are positioned directly adjacent to the teeth. All sensors OS1 and US1 are arranged intraorally, i.e., in the oral cavity of the patient. The sensors are fixedly connected to the respective teeth, and therefore they each form a location reference to the teeth and thus to the maxilla OK or mandible UK, respectively.
[0058] The sensors are arranged on opposing halves of the jaws UK, OK and therefore one of the sensors is arranged on the left side of the jaw UK, OK and the other sensor is arranged on the right side of the jaw OK, UK.
[0059]
[0060] The device 1 has a transmitter coil 8, which is arranged adjacent to a head 4 of the patient (shown very schematically as a rectangle). The transmitter coil 8 generates an electromagnetic measurement field 5, which penetrates the head 4 of the patient and can be acquired by the sensors OS1 and US1.
[0061] The sensors are designed as magnetic field sensors and enable at least one absolute position in the measurement field 5 to be acquired. An absolute position of the sensors relative to the transmitter coil 8 can therefore be determined from the sensor signals. The absolute position can be output, for example, in a coordinate system K, which is connected fixed in place to the transmitter coil 3, as XYZ coordinates. Optionally, in addition to the absolute position, i.e., three translational degrees of freedom, the sensors can acquire further, in particular rotational, degrees of freedom. The sensors US1 and OS1 are each designed in this exemplary embodiment as a six DOF sensor and are thus magnetic field sensors which can record three translational and three rotational degrees of freedom in the magnetic field as the measurement field. The sensor signals are relayed via the cable unit 2 to the analysis unit 3 and further processed therein. The analysis unit 3 is designed, for example, as a computer or as another digital data processing unit.
[0062] The analysis unit 3 has a storage unit 6, in which a 3D model of the maxilla OK and the mandible UK is stored. The sensors OS1 or US1, respectively, are entered and/or modeled in the 30 model. Once the positions relative to the transmitter coil 8 are known via the sensors, the 3D models of the maxilla OK or the mandible UK, respectively, can also be virtually arranged in the correct position in relation to one another. An overall model can thus be formed, in which the 3D models of the mandible UK and the maxilla OK are positioned in the correct location in relation to one another, and therefore the relative position in relation to one another is determined. A relative movement of the maxilla OK and the mandible UK can also be represented in the overall model. The overall model can then be output via an interface 7, in order to be able to be used further, for example in a virtual articulator and/or in a CAD system. In particular, the device enables a movement sequence to be output, wherein the movement sequence comprises multiple complex individual movement sequences such as opening, closing, chewing, etc., and to be represented, for example, like a film. In this manner, movement paths of the mandible relative to the maxilla can be determined.
[0063] The 3D models of the maxilla or the mandible, respectively, are provided, for example, via an intraoral scanner 9, which records the maxilla OK or the mandible UK, respectively, using the applied sensors. Alternatively thereto, an imprint of the maxilla OK or mandible UK, respectively, with an imprint of the sensors is digitized via a 3D scanner 10, in order to obtain the 3D models.
[0064] The measurement configuration is shown very schematically in
[0065] Various diagonal views of a U-shaped bite plate for a maxilla or mandible for toothless patients are shown in
[0066] The distancing unit is used to establish the occlusal plane and for bite registration during the production of a total maxilla and/or mandible prosthesis.
[0067] The distancing unit comprises bite plates, wherein one bite plate is arranged on the mandible and one bite plate is arranged on the maxilla.
[0068] By way of setting the pin with ball in the vertical direction and inclination, the distancing unit can determine the correct location and inclination of the jaws in relation to one another and facilitates the measuring of the occlusal plane for the production of prostheses.
[0069] Alternatively, the distancing unit can have multiple pins, wherein the pins are arranged in the rear and/or lateral region of the bite plates and do not have a ball joint.
[0070] The bite plate particularly advantageously enables the patient to independently find an anatomically correct condyle position, even if it was previously lost.
[0071] Moreover, a UK recording can be produced on toothless patients using the unit for attaching the markers.
[0072] The respective bite plate has a centrally arranged pin or multiple pins, wherein at least the pin has a ball having a threaded borehole, in which the pin is arranged such that it is at least vertically adjustable, cf.
[0073]
[0074] A position marking is formed as an indentation or recess in the curved surface region of the sensor shoe facing away from the respective tooth. In particular, the position marking is formed as a conical recess, and therefore its tip defines a zero point of the relationship of the sensor to the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK). The tip of the position marking is in a direct relationship to a planar surface region around the recess of the sensor shoe, wherein the sensor position is defined with respect to the relative position and/or relative movement of the mandible (UK) relative to the maxilla (OK).
[0075]
[0076] The magnetic field generator and the sensor shoes/markers are used for transferring the positions in the mouth by means of corresponding software to the transfer table, wherein the magnetic field generator is positioned at the worktable. The sensor/marker position at the transfer table is compared to the position in the mouth of the patient via the software. The correct positioning of the plaster model in the transfer table is indicated via the sensor shoes/markers fastened here via the software.
[0077] The articulator or movement simulator simulates the movements recorded in the mouth. To be able to set a therapeutic position in the case of patients or also total prosthesis wearers, markers can also be attached to the movement simulator, which are then in turn actuated via the software.
[0078] Via micrometer screws, x, y, and z axes can be adjusted and the therapeutic situation can thus be defined and established in the software, wherein the condyle boxes and condyle axes are also adjustable, since the condyles are located at different distances from one another in different people.
[0079] The movement sequence is completely created in the movement simulator, and therefore movement paths are compared to a UK movement acquisition created according to the dental prosthesis classification.
[0080] Irritation of the patient is completely avoided and free movements including chewing are possible during the UK movement recording for the first time.
LIST OF REFERENCE SIGNS
[0081] 1 device [0082] 2 cable connection [0083] 3 analysis unit [0084] 4 head [0085] 5 electromagnetic measurement field [0086] 6 storage unit [0087] 7 interface [0088] 8 transmitter coil [0089] 9 intraoral scanner [0090] 10 3D scanner [0091] D triangle [0092] K coordinate system [0093] O1-8 teeth [0094] OD triangle [0095] OE plane [0096] OK maxilla [0097] OS1 maxilla sensor [0098] U1-8 teeth [0099] UK mandible [0100] US1 mandible sensor