Abstract:
A system comprises a computer appliance designed to receive, and to present on screen, first information transmitted from identification equipment and based on detection of a jaw bone structure. Modification information which can be introduced into the computer appliance shows a visual dental bridge structure applied on the jaw bone structure with associated teeth and dentine. Orientations for implants are also shown. The computer appliance produces a CAD file which is based on the first information and the modification information. The file is received in a stereolithography machine which issues second information which can be processed in the equipment for production of the physical template which includes through-bores for sleeves which define implant orientation. A working model is produced with the aid of the physical template. The invention also relates to an arrangement of a template produced by stereolithography and by means of information from the computer appliance.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a divisional of U.S. application Ser. No. 10/582,417, which is the U.S. National Phase under 35 U.S.C. §371 of International Application No. PCT/SE04/01527, filed Oct. 22, 2004, which claims priority under 35 U.S.C. §119 to Swedish Patent Application No. SE 0303309-9, filed Dec. 10, 2003, the disclosures of which are incorporated in their entirety by reference herein. 
    
    
     BACKGROUND OF THE INVENTION 
     The following disclosure relates inter alia to a system for production and insertion of a real dental bridge structure in a real jaw bone structure by means of a number of successive steps performed using equipment belonging to one or more parties. 
     SUMMARY 
     In certain embodiments, the equipment comprises identification equipment, a computer appliance, stereolithography equipment, equipment for production of a physical template, equipment for production of a working model in cooperation with an articulator, equipment for production of the dental bridge structure and insertion equipment for fitting the dental bridge structure on the implant in the jaw bone structure. Jaw bone structure can relate, for example, to the structure of the upper jaw or lower jaw. The disclosure also relates to a template produced by stereolithography and from information from the computer appliance and used for producing, on the one hand, a dental bridge structure that can be applied on an implant in the jaw bone structure, and, on the other hand, for guiding of hole-forming means, for example a drill, for forming holes for the implants. Generally similar systems may be found in patent application no. SE 0004884-3. 
     Previous templates are described in patent application nos. SE 0004885-0, SE 0004886-8, SE 0104431-2, SE 0104432-0, SE 0203898-2, SE 0203899-0 and SE 0203900-6. 
     There is a need for reducing the time and cost associated with making and/or using dental templates. Thus, for example, the production of the template may be reduced by 30-50% and, among other advantages, the stereolithography be reduced. Embodiments described herein allow for relatively high precision while reducing the time and cost associated with production. 
     In accordance with the disclosure, some or all of the production steps or functions may be performed by parties already operating on the market. The parties may cooperate with one another, the number of parties may be able to vary and the production steps may be divided into testing, insertion and handling, production by means of STL (sterolithography technology) and model production, and production by the dental technician. For support and possible production of one or more of the functions, other parties may be involved. Such parties may include parties who provide a generally fully automatic production system for dental products such as the PROCERA® type. 
     A system according to embodiments of the disclosure is a computer appliance designed to receive, and present on screen, first information transmitted from a identification equipment and based on detection of a jaw bone structure. The computer appliance can be arranged with operating elements which may be used to modification information concerning, on the one hand, a visual dental bridge structure applied on the visual jaw bone structure with associated teeth and dentine. The computer appliance may further be used to modify orientations of the implants in the visual dental bridge structure and visual jaw bone structure. Moreover, the computer appliance is arranged to generate or to cause generation of a CAD file based on the first information and the modification information and to transmit the CAD file to the stereolithography machine. Second information can be processed using the equipment for production of a physical template which includes through-bores for sleeves arranged to determine the recessed positions and longitudinal directions for one or more implants. The physical template can on the one hand form the basis for production of a working model and, on the other hand, serve as template for forming holes in the jawbone defined with the sleeves using insertion equipment (e.g., drill). 
     In some embodiment, the identification and computer appliances can be assigned to a first party consisting of a party treating a patient, such as, for example a surgeon or dentist. The stereolithography machine can be assigned to a second party. The equipment for production of the template, working model and real dental bridge structure can be assigned to a third party, for example a dental technician. A fourth party with equipment of a higher order can also be involved. The fourth party can ensure, for example, the provision of information and/or handling or production of one or more of said functions or parts thereof. In certain embodiments, the stereolithography machine can be accessed by any of said parties. 
     An arrangement according to the disclosure includes a template and dental bridge structure provided with through-holes, the through-holes provided with sleeves. The sleeves can define, for example, the degree to which the implants are recessed and their orientation. 
     In further embodiments, the sleeves are designed to achieve a degree or amount of recessing in the template. In one embodiment, the sleeves can be anchored to the template with dental cement. In a preferred embodiment, the template is arranged to reproduce or comprise a material or part which corresponds to the dentine or gum replacement over those parts which extend over the portions of jaw bone the dental bridge is intended to extend over. In some embodiments, the template is produced in said machine from plastic material with a very low coefficient of shrinkage. 
     In some embodiments, after fixture planning, planning files can be converted to CAD files and SLA models (rapid prototyping) can be ordered in so-called STL technology. Part of the model can simulate the patient&#39;s upper jaw or lower jaw, while another part simulates the patient&#39;s dental prosthesis. Thereafter, the working model is produced at the dental laboratory. The template can be planned on a computer using CAD and includes data or information which can be used to order a template produced by STL technology. The template can include sleeves for guiding the drill, implant and anchoring pins. The sleeves can be cemented in place with dental cement. 
     The template can be used as an impression for producing a working model (e.g., in plaster), which can be mounted in an articulator (e.g., with the aid of a bite index against the dental model of the opposite jaw/jaw bone). The dental bridge can be produced on the working model. The template can also form the gum replacement over the implant in the jaw bone and around spacers in connection with production of the working model. 
     Embodiments of systems and methods according to the embodiments of the disclosure will be described below with reference to the attached drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  shows, in block diagram form, example equipment and parties involved according to embodiments described herein. 
         FIG. 2  shows upper and lower jaws of a patient, a bridge and a template according to embodiments described herein. 
         FIG. 3  shows, in vertical cross-section, two different embodiments of sleeves used in the template according to embodiments described herein. 
         FIG. 4  shows, in vertical cross-section, application of a sleeve in relation to an implant, and a fastening screw for the sleeve and the implant according to embodiments described herein. 
         FIG. 5  shows, from underneath, a model of an upper jaw in which implants are applied with associated anchoring tubes and anchoring pins which extend horizontally in the dentine between the implants according to embodiments described herein. 
         FIG. 6  shows a top view of the model according to  FIG. 5 ; and 
         FIG. 7  shows a perspective view, from the side, of implants and anchoring pins in an upper jaw according to embodiments described herein. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     A template can be planned using a computer (e.g., using a CAD tool) by modifying the scanned patient prosthesis. In this way, it is possible to avoid the problem of having to produce the template at a dental laboratory. This is an advantage since the template there is made of acrylic or of a plastic which has a certain shrinkage tendency, with deterioration of the precision as a consequence. According to the disclosure, the template can be mounted in the articulator with the aid of a bite index. In this way, it is possible to record the bite relationships of the jaws. The template is used by the surgeon to place the implant at a planned site in the patient&#39;s mouth. Anchoring pins which are inserted from the side of the template between the planned implants may be included. In this way, the template is held in place in the mouth with the aid of a bite index which is produced by the dental technician in the articulator. This solves the problem of obtaining the correct bite relationship between the dental bridge and the opposite jaw after the operation. The template includes data for planning, so that it is generally not necessary to produce the bone part of the patient&#39;s jaw. This reduces the production time and costs associated with using the stereolithography machine. Error placing the prosthesis model in the correct relationship to the bone part is reduced. 
     In  FIG. 1 , a first party is indicated symbolically by  1 , a second party by  2 , and a third party by  3 . The first party can be a surgeon, dentist, etc., who is to test and fit a dental bridge on a patient  4 . The second party can be an owner of a stereolithography machine. The third party can be a dental technician.  FIG. 1  also indicates a fourth party represented by a generally automatic production system for dental products; in the illustrative embodiment the party  5  is designated as PROCERA®. The first party may have access to identification equipment  6 . In addition, the first party has access to a computer appliance  7 . The stereolithography machine is symbolized by  8 . The dental technician has access to equipment for production of a physical template  9 , and equipment  10  for production of a working model in cooperation with an articulator function. In addition, the dental technician produces the final dental bridge using equipment  11 . 
     The identification equipment  6  may include conventional identification equipment. Thus, for example, the party  1  can produce an impression using conventional means. Alternatively, cameras, laser equipment, etc., can be used. The computer appliance  7  comprises, a computer screen  7   a  and an operating element  7   b  which can consist of a keyboard, voice communication unit, etc. Depending on the identification, the relevant jaw/jaw bone, in this case upper jaw, of the patient  4  can be indicated. The upper jaw structure is symbolized by  7   c . In addition, the first party can modify the computer model of the jaw bone structure on the screen and build up a dental crown structure applied on the jaw bone. Such a structure is indicated by  7   d . For the sake of clarity, the upper jaw  7   c  and the complete structure  7   d  have been shown as two simultaneous representations. Said representations can of course be indicated one at a time. In the representation  7   d , the orientations for the implants and their directions are shown by  7   e . The computer appliance can operate with conventional programs (CAD programs) and file management systems. 
     The scanning equipment  6  of certain embodiments can provide the computer appliance with first information  12  which represents the scanned jaw bone structure. This is exported to the computer appliance. In turn, the computer appliance generates a CAD file which is represented by  13  in  FIG. 1 . The CAD file is received by the stereolithography machine which sets the conditions for a physical model transferred to the dental technician  9  for application of sleeves, inter alia. This transfer is represented by  14 . The physical model is shown by  15 . The dental technician uses the model  15  for production of a working model  16 , and the transfer function between the units  9  and  10  is symbolized by  17 . The production of the working model takes place in conjunction with an articulator function which is represented by  18 . The bite index for the articulator function can be transferred from the patient  4 , the computer appliance  7  and/or the identification equipment  6 . Said transfers are represented by  19 ,  20  and  21 . The bite index transfer to the articulator function has been symbolized by  22 . 
     The real dental bridge  23  is produced in the equipment  11  by the party  3 . From the equipment  9 , the physical template  15  can be transferred to the surgeon or equivalent. This transfer is represented by  24 . The party  1  can also have access to equipment symbolized by  1 A. This equipment can include drilling equipment and insertion equipment for fitting the template and dental bridge on the patient  4 . The finished dental bridge can be transferred to the first party, as has been represented by the transfer arrow  26 . Formation of holes in the patient&#39;s jaw bone with the aid of the template and insertion of the finished dental bridge can take place in a manner known per se and will therefore not be described in detail here. 
     In accordance with  FIG. 1 , the fourth party  5  can provide a support function or production of one or more of said function steps. This is shown in the figure where the automatic system comprises adaptation units  27 ,  28 ,  29  and  30 . The equipment of the other parties can also be connected via adaptation units  31 ,  32 ,  33 ,  34 ,  35 ,  36 ,  37  and  38 . The transfers can take place via general communication means  39 , for example the telecommunications network, Internet, computer network, etc. The transfer functions are represented by bi-directional arrows, indicating two-way communications. The arrows are represented by  40 . 
     In  FIG. 2 , an upper jaw of a patient is indicated by  41  and a lower jaw by  42 . In the upper jaw, the party  1  has inserted implants  43  in which a dental bridge is to be secured. A set of teeth in the patient&#39;s lower jaw is indicated by  44  and, in accordance with embodiments described herein, the bite relationship between the dental bridge to be implanted and the teeth of the lower jaw can be implemented and/or determined with the aid of a bite index. Reference number  45  indicates a template in accordance with the above. The template comprises recesses  46  for sleeves  47 . The sleeves can be used as guide members for formation of holes  48  into which the implants  43  can be screwed or recessed. Reference number  49  indicates the finished dental bridge structure to be anchored on the implants  43  in the upper jaw. The upper jaw is also shown diagrammatically from underneath by reference number  50  in order to indicate orientations for anchoring pins  51  which may extend substantially in a horizontal plane in the jaw structure.  FIG. 3  shows a first embodiment of a sleeve  52  which is used for guiding a drill  53  for forming the implant hole  48 . The sleeve has a stop edge  52   a  which can cooperate with the template  54  via a stop surface  54   a  on the latter.  FIG. 3  also shows a second embodiment  55  of a sleeve  56  which is provided with slits  56   a . The template  57  in this case has an internal recess  57   a  into which a snap-fit flange  56   b  on the sleeve can snap when the sleeve assumes its final position in the template  57 . A click noise may sound upon snap-fitting of the flange  56   b  into the recess  57 . 
       FIG. 4  shows an implant  60  applied in a jaw bone and dentine  59 . The implant can cooperate with an attachment part  61  over which a sleeve  62  in accordance with the above can be engaged. The components can be held together with a retaining screw  63 . The sleeve  62  may be mounted in the template or dental bridge part which is indicated by  64 . The parts are shown in the disassembled state for the sake of clarity. The parts can be joined together in the direction of the arrow  65 . A through-hole in the template  64  is shown by  64   a . Cement which is used for securing the sleeve to the template is shown symbolically by  52   b.    
     A structural configuration of a physical template is indicated by  66  of  FIG. 5  and  FIG. 6 . In the present embodiment, implants  67  are secured to the template in an assembled configuration. The anchoring pins are shown by  68 .  FIG. 6  shows the template according to  FIG. 5  from underneath. The anchoring pins  68  are designed with manual actuating members configured to allow for screwing of the pins through the jaw bone. As shown, the anchoring pins may extend between the implants  67 . 
       FIG. 7  shows, from the side and in perspective, the template according to  FIGS. 5 and 6  applied to a jaw bone  69 . 
     Although this disclosure has been described in terms of example embodiments and applications, other embodiments and applications apparent to those of ordinary skill in the art, including embodiments and applications that do not provide all of the benefits described herein, are also within the scope of this disclosure. The scope of the inventions is defined only by the claims, which are intended to be construed without reference to any definitions that may be explicitly or implicitly included in any of the incorporated-by-reference materials.