Patent Description:
In an implant treatment for example, a dentist who is an operator, usually obtains a three-dimensional image of the upper jaw and/or the lower jaw, including a treatment position of the patient, using dental CT scanning. Based on the three-dimensional image, the dentist grasps, prior to the procedures, the position of the maxillary sinus and the positions of the posterior superior alveolar artery and the greater palatine artery of the upper jaw of the patient, or the positions of the inferior alveolar artery and the inferior alveolar nerve of the lower jaw of the patient, as well as the treatment position.

If the treatment objective is the upper jaw in an implant treatment for example, the dentist performs procedures in such a manner that the distal end of a hole-forming instrument such as a drill does not reach predetermined not-to-be-reached (not-to-be-contacted) targets, such as the maxillary sinus mucosa, the posterior superior alveolar artery, and the greater palatine artery of the patient. If the treatment objective is the lower jaw, the dentist performs procedures in such a manner that the distal end of the hole-forming instrument such as a drill does not reach predetermined not-to-be-reached targets, such as the inferior alveolar artery and the inferior alveolar nerve of the patient. <CIT> relates to a 3D printed bone supported sinus guide for edentulous maxillary arch.

The risk of implant treatment lies in, for example, that positions of not-to-be-reached targets such as arteries and nerves cannot be visually recognized during procedures.

The present invention aims at providing a model for pre-procedure verification of a dental treatment plan, a pre-procedure verification instrument of the dental treatment plan, a method of manufacturing a model for the pre-procedure verification of the dental treatment plan, a pre-procedure verification system of the dental treatment plan, and a pre-procedure verification program of the dental treatment plan which allow a dentist who is an operator, to perform, when performing, for example, a treatment of embedding an implant body, a treatment of embedding an embedded body such as an autologous tooth, etc., advance verification of a positional relationship between a position of a distal end of a procedural instrument during use of the procedural instrument and positions of not-to-be-reached targets of a patient such as positions of the maxillary sinus mucosa, the posterior superior alveolar artery, and the greater palatine artery of the upper jaw or positions of the inferior alveolar artery and the inferior alveolar nerve of the lower jaw, prior to a dental treatment using the procedural instrument such as an actual hole-forming instrument, after creating the treatment plan.

According to one aspect of the present invention, there is provided a model for pre-procedure verification of a dental treatment plan. The model includes a model main body, an opening defining portion, and a target model portion. The model main body is formed based on a jaw of a patient in a size and a shape identical to at least a part of a treatment objective site of the jaw of the patient and configured to model the at least a part of the treatment objective site. The opening defining portion is provided in the model main body and is configured to define an opening corresponding to a recessed opening for embedding an embedded body in the treatment objective site. The target model portion is configured to model a target adjacent to or embedded in an alveolar bone of the treatment objective site. The target model portion allows a distal end of a procedural instrument used for a treatment to be out of contact with the target model portion under a condition that the procedural instrument passes through the opening defining portion in a positional relationship of the target model portion identical to a positional relationship of the target relative to the treatment objective site, or allows the distal end of the procedural instrument to be in contact with the target model portion under a condition that the procedural instrument passes through the opening defining portion in a positional relationship of the target model portion closer than the positional relationship of the target relative to the treatment objective site. A space is formed between the opening defining portion and the target model portion to allow visual recognition of a range present between the opening defining portion and the target model portion. The range including a reachable range of the distal end of the procedural instrument from the opening defining portion toward the target model portion and a reachable range of the distal end of the procedural instrument from the opening defining portion in a teeth alignment direction and a direction intersecting the teeth alignment direction.

<FIG> is a schematic diagram showing a state of a series of processes leading to a three-dimensional image of a model of the upper jaw, according to a modification of a second embodiment.

A pre-procedure verification system (model production system for verifying a dental treatment plan prior to procedures after creation of the dental treatment plan) <NUM> of a dental treatment plan according to an embodiment forms part of a series of operations from, for example, acquisition of various types of data of a patient and creation of a treatment plan of an implant treatment to performance of procedures on the patient. The system <NUM> is used in performing a series of operations from acquisition of patient data of a patient, creation of a dental treatment plan for the patient, to performance of pre-procedure verification of the dental treatment plan using an output of the model (model for pre-procedure verification of the dental treatment plan) <NUM> of the actual patient. The acquisition of patient data of a patient and the output of the model <NUM> may be performed by a system different from the system <NUM>. The model <NUM> according to the present embodiment is a real-size model.

In the first embodiment, a case will be described where a system <NUM> is used in an example of performing an implant treatment in which an implant body <NUM> (see <FIG>), selected from a multitude, is embedded as an embedded body in the lower jaw of the patient.

As shown in <FIG>, a pre-procedure verification system (hereinafter simply referred to as a "system") <NUM> of a dental treatment plan includes a control apparatus <NUM>, a first scanner <NUM>, a second scanner <NUM>, a display <NUM>, an operation portion (instruction input portion) <NUM>, a storage apparatus <NUM>, a 3D printer <NUM>, and a milling machine <NUM>.

The control apparatus <NUM> controls the first scanner <NUM>, the second scanner <NUM>, the display <NUM>, the operation portion <NUM>, the storage apparatus <NUM>, the 3D printer <NUM>, and the milling machine <NUM>. Examples of the control apparatus <NUM> that may be used include a computer. The control apparatus <NUM> includes, for example, a processor such as a CPU and an MPU as well as a RAM, a ROM, and an I/O interface. The control apparatus <NUM> causes one or more processors such as CPUs in a memory such as a ROM to develop a control program stored in a memory such as a ROM into a RAM, and execute suitable processing on the display <NUM>, the operation portion <NUM>, the storage apparatus <NUM>, the first scanner <NUM>, the second scanner <NUM>, the 3D printer <NUM>, and the milling machine <NUM>. Alternatively, the control apparatus <NUM> causes one or more processors such as CPUs to read a program via a network, and execute suitable processing on the display <NUM>, the operation portion <NUM>, the storage apparatus <NUM>, the first scanner <NUM>, the second scanner <NUM>, the 3D printer <NUM>, and the milling machine <NUM>. The control apparatus <NUM> causes the processor to read and execute programs stored in a memory in advance to control each component, thereby realizing the function of performing processing such as image processing by means of software.

The first scanner <NUM> is based on, for example, dental CT scanning. The first scanner <NUM> acquires a three-dimensional image (e.g., DICOM data) of, for example, the teeth, the bone, and the inside of the bone of the lower jaw of the patient, and outputs it to the control apparatus <NUM>. The control apparatus <NUM> causes the storage apparatus <NUM> to store the three-dimensional image of the teeth, the bone, and the inside of the bone of the lower jaw of the patient. The second scanner <NUM> is, for example, an intraoral scanner. The second scanner <NUM> acquires, for example, a three-dimensional image (e.g., STL data) of the surface of the teeth and the gums of the lower jaw of the patient, and outputs it to the control apparatus <NUM>. The control apparatus <NUM> causes the storage apparatus <NUM> to store the three-dimensional image of the surface of the teeth and the gums of the lower jaw of the patient.

The display <NUM> is, for example, a variety of displays such as a liquid crystal display and an organic electroluminescence (EL) display. The display <NUM> displays a patient-related image acquired by the first scanner <NUM> and the second scanner <NUM> to be output to the control apparatus <NUM> and displays a variety of information. The control apparatus <NUM> may read a three-dimensional image of the patient stored in the storage apparatus <NUM> and cause the display <NUM> to display the three-dimensional image.

The operation portion <NUM> inputs an instruction to the control apparatus <NUM>. The operation portion <NUM> includes, for example, a device such as a keyboard and a mouse.

The storage apparatus <NUM> stores various types of data on a patient (e.g., a three-dimensional image (e.g., DICOM data) of the teeth, the bone, and the inside of the bone of the lower jaw, and a three-dimensional image (e.g., STL data) of the surface of the teeth and the gums of the lower jaw of the patient. The storage apparatus <NUM> stores, for example, a variety of three-dimensional images (implant body data) 22a of an implant body <NUM> shown in <FIG>, and a variety of three-dimensional images (hole-forming instrument set data) 22b of a hole-forming instrument <NUM> such as a drill shown in <FIG>.

If the control apparatus <NUM> reads, via a network, a variety of three-dimensional images 22a of the implant body <NUM> and a variety of three-dimensional images 22b of the hole-forming instrument <NUM>, the storing of the variety of three-dimensional images 22a of the implant body <NUM> and the variety of three-dimensional images 22b of the hole-forming instrument <NUM> in the storage apparatus <NUM> may be eliminated. That is, the control apparatus <NUM> may use, for example, a database (the implant body data 22a and the hole-forming instrument set data 22b) on a server instead of the storage apparatus <NUM>. The control apparatus <NUM> is configured to read a variety of data from the server.

As shown in <FIG>, the actual hole-forming instrument <NUM> includes, for example, a body <NUM> that bores a hole, a shank <NUM>, a sleeve <NUM>, and a stopper <NUM>. The body <NUM> and the shank <NUM> are made integral by, for example, integral molding. The shank <NUM> is fixed to an unillustrated handpiece. This allows the body <NUM> and the shank <NUM> to be rotated around a predetermined rotation axis. The sleeve <NUM> covers the outer side of the body <NUM>, and fits into or engages with a guide opening (through opening) <NUM> of an adjunctive instrument <NUM> such as a surgical guide, to be described later. An end surface 48a on the side of the body <NUM> of the stopper <NUM> abuts a defining surface <NUM> which defines the guide opening <NUM> of the adjunctive instrument <NUM>, with a distance to the handpiece being defined, for example.

The 3D printer <NUM> constructs a model <NUM> for advance verification of a dental treatment shown in <FIG>, based on a three-dimensional image of the lower jaw of the patient and a three-dimensional image created by a dental treatment planner such as a dentist. It is preferable, for example, that the 3D printer <NUM> be owned by a dentist himself/herself who operates the 3D printer <NUM>; however, a professional, etc. may receive data for the 3D printer from a dentist, etc. and output a construction.

It is preferable that the 3D printer <NUM> according to the present embodiment be formed to automatically construct, at the time of output, a support material (a base portion (foundation) <NUM> and one or more pillars <NUM> to be described later), together with a model main body <NUM> in which an opening portion (opening defining portion) <NUM> is provided, and a target model portion <NUM>. A dentist, etc. may suitably place a support material in a fifth three-dimensional image <NUM>, to be described later, prior to the output by the 3D printer <NUM>.

The model <NUM> includes a model main body <NUM>, a target model portion <NUM>, and an opening portion (opening defining portion) <NUM>. The model main body <NUM> is constructed to have the same size and shape as those of the treatment objective site and its periphery of the actual lower jaw of the patient. The model main body <NUM> need not cover the entire lower jaw, and should only cover the treatment objective site and its periphery of the lower jaw. It is preferable that the model main body <NUM> be formed to cover the same range as the region in which an adjunctive instrument (surgical guide) <NUM>, to be described later, is fixed to the treatment objective site and its periphery of the actual lower jaw of the patient, or is formed as a greater surface model. It is preferable that much of the site corresponding to the inferior alveolar bone of the patient not be present in the model <NUM>. The model main body <NUM> and the target model portion <NUM> are formed to have the same positional relationship as the positional relationship between the treatment objective site and a target (a not-to-be-contacted target or a to-be-contacted target) of the actual lower jaw of the patient. The same positional relationship means that the site relating to procedures of the treatment objective site is formed to have the same size and shape as the treatment objective site and its periphery of the actual lower jaw of the patient. The opening portion <NUM> is defined by a variety of parameters of the implant body <NUM> and the hole-forming instrument <NUM>, which will be described later. The opening portion <NUM> is formed in accordance with settings of parameters relating to the shape (e.g., the length, the outer diameter, etc.), the angle, and the position of the implant body <NUM> or the hole-forming instrument <NUM> to be embedded in the opening portion <NUM> of the treatment objective site.

The model main body <NUM> has a defining surface <NUM> that forms an edge of the opening portion <NUM>. The defining surface <NUM> is a surface of the gums or the inferior alveolar bone. If an end surface 46a of the sleeve <NUM> of the hole-forming instrument <NUM> abuts the defining surface <NUM>, the body <NUM> of the hole-forming instrument <NUM> is restricted from going toward the back side of the gums and the inferior alveolar bone from that position. Thus, a distal end reaching position of the hole-forming instrument <NUM> is defined by the defining surface <NUM> of the model main body <NUM>.

It is preferable that the target model portion <NUM> be supported on the model main body <NUM> with a main pillar <NUM>. A space (space defining portion) <NUM> is formed between the opening portion <NUM> and the target model portion <NUM> to allow the dentist, etc. to visually recognize, from outside the model <NUM>, a reachable range of the distal end of the hole-forming instrument <NUM> from the opening portion <NUM> toward the target model portion <NUM>, and the range within which the distal end of the hole-forming instrument <NUM> may reach from the opening portion <NUM> in a teeth alignment direction and a direction intersecting the teeth alignment direction. That is, the space <NUM> is formed between the model main body <NUM> and the target model portion <NUM> to allow a dentist, etc. to confirm whether a distal end of the body <NUM> of the hole-forming instrument <NUM> is, for example, in contact with or out of contact with the target model portion <NUM>. In the present embodiment, the main pillar <NUM> and the target model portion <NUM> are formed as an approximately L-shaped member. The main pillar <NUM> is formed as a part of a frame that defines the space <NUM>, together with the model main body <NUM>, the target model portion <NUM>, etc..

The model <NUM> further includes a base portion (foundation) <NUM> provided on a side opposite to the model main body <NUM> to support the target model portion <NUM>, and one or more pillars (supports) <NUM> connecting the model main body <NUM> and the base portion <NUM>.

It is preferable that a position corresponding to the cheek side and/or the lip side of the alveolar bone between the model main body <NUM> and the target model portion <NUM> be accessible to the target model portion <NUM> from the side of the position corresponding to the cheek side and/or the lip side of the alveolar bone as a wall-less window portion.

The milling machine <NUM> carves the adjunctive instrument (surgical guide) <NUM> shown in <FIG> based on the three-dimensional image of the lower jaw of the patient and the three-dimensional image created by the dentist. It is preferable that the milling machine <NUM> be owned by a dentist himself/herself who operates the milling machine <NUM>; however, a professional, etc. may receive data for the milling machine <NUM> from a dentist, etc. and output the adjunctive instrument <NUM>.

For actual use during a dental treatment, a medically approved resin material having a durability that withstands the dental treatment is used as the adjunctive instrument <NUM>. The adjunctive instrument <NUM> used during a dental treatment may be produced by the 3D printer <NUM>. In this case, the adjunctive instrument <NUM> is formed of a medically approved material. It is preferable that the adjunctive instrument <NUM>, which is used for the dentist's confirmation together with the model <NUM>, not be used during a dental treatment, and is formed of, for example, the same material as that of the model <NUM>. The model <NUM>, which is not used for an actual treatment, may be formed of a suitable material with a suitable precision, as long as the relationship between the defining surface <NUM> and the target model portion <NUM> is maintained.

The adjunctive instrument <NUM> is formed to conform to the surface shape of a three-dimensional image of the surface of the teeth and the gums and/or a CT image of a treatment portion of the patient. The adjunctive instrument <NUM> is used by being fixedly screwed to, and then fitted into, the teeth in the vicinity of the gums of the treatment portion, the gums, or the jawbone of the patient. The adjunctive instrument <NUM> is fixed to the lower jaw so as not to wobble in the lower jaw. The adjunctive instrument <NUM> is used to form a recessed opening set in the gums and the alveolar bone, and to precisely form a recessed opening for receiving the set implant body <NUM> in the body <NUM> of the hole-forming instrument <NUM>.

The adjunctive instrument <NUM> is used together with the model <NUM> for pre-procedure verification for a dental treatment plan, as well as during a dental treatment. As shown in <FIG>, a combination of the model <NUM> for pre-procedure verification of a dental treatment plan and the adjunctive instrument <NUM> is referred to as a pre-procedure verification instrument <NUM> of a dental treatment plan.

The adjunctive instrument <NUM> shown in <FIG> includes a main body <NUM> and a guide opening <NUM>.

Since the adjunctive instrument <NUM> is used by being fixedly screwed to, and then fitted into the teeth in the vicinity of the gums of the treatment portion, the gum, or the jawbone of the patient, as described above, the main body <NUM> is used as a position defining portion that defines a referential position relative to the teeth, the gums, and the jawbone. An example is shown in which the main body <NUM> is fixed along one or more teeth in the oral cavity region of the patient; however, there may be completely no teeth on the lower jaw side of the patient. The main body <NUM> may be configured, for example, to be connected to a smaller part of the oral cavity of the patient, such as to only one or two teeth, only a bone, or a given combination thereof.

With the main body <NUM> appropriately attached to the teeth and the gums of the lower jaw of the patient, the guide opening <NUM> defines the direction, the shape (the length and the outer diameter), the angle, the position, etc. of a recessed opening formed by the body <NUM> of the hole-forming instrument <NUM>. The adjunctive instrument <NUM> includes a defining surface <NUM> that forms an edge of the guide opening <NUM>. The defining surface <NUM> is a surface on a side opposite to a surface that faces the gums or the inferior alveolar bone. If an end surface 48a of the stopper <NUM> abuts the defining surface <NUM>, the body <NUM> of the hole-forming instrument <NUM> is restricted from going toward the back side of the gums and the inferior alveolar bone from that position. Thus, a distal end reaching position of the hole-forming instrument <NUM> is defined by the defining surface <NUM> of the adjunctive instrument <NUM>.

It is to be noted that not only the hole-forming instrument <NUM> but also other procedural instruments such as an electrosurgical knife for hemostasis, for example, may be inserted into the guide opening <NUM> of the adjunctive instrument <NUM>. At this time, the defining surface <NUM> restricts the direction, the angle, the position, etc. of insertion of the electrosurgical knife. Thus, the defining surface <NUM> may be used not only as a restricting surface of the hole-forming instrument <NUM>, but also as a restricting surface of other procedural instruments. Accordingly, the adjunctive instrument <NUM> is used as a position defining body of the procedural instrument. The guide opening <NUM> is usually formed as a circular opening.

It is to be noted that, with the system <NUM> according to the present embodiment, a dentist is capable of creating the adjunctive instrument <NUM> as a three-dimensional image (data representing a three-dimensional shape), and constructing an actual object that fits the shape and size of the lower jaw of the patient, using the 3D printer <NUM> or the milling machine <NUM>.

In the storage apparatus <NUM> according to the present embodiment, an image display program, an image processing program, an output program, etc. are stored. The image display program, the image processing program, the output program, etc. are executed by the control apparatus <NUM>.

The image display program allows data acquired by the first scanner <NUM> and the second scanner <NUM> to be displayed on the display <NUM>. The image processing program superimposes an image (image data) displayed by the image display program and a variety of data stored in the storage apparatus <NUM> based on an identical coordinate axis. The image display program allows the data obtained by the superimposition based on the identical coordinate axis using the image processing program to be displayed on the display <NUM>. The image display program allows a three-dimensional image created based on the dentist's intention to be displayed on the display <NUM>. The output program outputs surface data (which refers to data (three-dimensional image data) representing a three-dimensional shape, and will be hereinafter referred to as "surface data") of three-dimensional images and objects (e.g., the model <NUM> and the adjunctive instrument <NUM>) created based on the dentist's intention using the image processing program. The output program is configured to output surface data that allows the 3D printer <NUM> or the milling machine <NUM> to construct an actual object.

The dentist inputs a variety of instructions to the control apparatus <NUM> using the operation portion <NUM>, and creates a treatment plan of an implant treatment in accordance with, for example, the flows shown in <FIG> and <FIG>.

The control apparatus (computer) <NUM> acquires a three-dimensional image (e.g., DICOM data) of the teeth, the bone, and the inside of the bone of the lower jaw of the patient using, for example, the first scanner <NUM>, which is based on dental CT scanning or the like, and causes the storage apparatus <NUM> to store the acquired three-dimensional image. This is referred to as a first three-dimensional image (three-dimensional image data) <NUM>. Also, the control apparatus (computer) <NUM> acquires a three-dimensional image (e.g., STL data) of the surface of the teeth and the gums using the second scanner <NUM>, which is, for example, an intraoral scanner, and causes the storage apparatus <NUM> to store the acquired three-dimensional image. This is referred to as a second three-dimensional image (three-dimensional image data) <NUM>, namely, first surface data. The second three-dimensional image <NUM> (first surface data) includes a treatment objective site and its peripheral site. The control apparatus (computer) <NUM> imports the first three-dimensional image <NUM> and the second three-dimensional image <NUM> in a suitable piece of software (an application) based on the dentist's instruction (step S1). In the software, data of both the first three-dimensional image <NUM> and the second three-dimensional image <NUM> can be read, even if the first three-dimensional image <NUM> and the second three-dimensional image <NUM> are in different data formats.

It is to be noted that the "dentist's instruction" in the present embodiment includes various examples such as simply clicking a computer mouse.

The dentist confirms, for example, the first three-dimensional image <NUM> on a display screen of the display <NUM>, and comprehensively judges whether or not it is possible to perform an implant treatment on a treatment site of a patient based on various other conditions (step S2). Hereinafter, an operation in the case where the dentist has judged that an implant treatment is possible (step S2-Yes) will be described. It is to be noted that, if the dentist has judged that an implant treatment is impossible (step S2-No), an operation of creating a treatment plan ends.

It is to be noted that, if the second three-dimensional image <NUM> is not used for judging whether or not an implant treatment is possible, acquisition of a three-dimensional image of the surface of the teeth and the gums using the second scanner <NUM> may be performed after step S2.

As shown in <FIG>, based on the dentist's instruction, the control apparatus <NUM> specifies, on a software-based screen of the display <NUM>, the positions of the inferior alveolar artery and the inferior alveolar nerve in the first three-dimensional image <NUM> indicating the bone (inferior alveolar bone) of the lower jaw. The positions of the inferior alveolar artery and the inferior alveolar nerve are, for example, not-to-be-reached (not-to-be-contacted) targets that must not be reached by a distal end of the body <NUM> of the hole-forming instrument <NUM> during formation of a recessed opening <NUM> into which an implant body <NUM> is to be embedded during an implant treatment. Based on the dentist's instruction, the control apparatus <NUM> marks, on the screen of the display <NUM>, the positions of the not-to-be-reached targets (step S3; first process). At this time, based on the dentist's instruction, the control apparatus <NUM> marks, on the screen of the display <NUM>, characteristic points of the not-to-be-reached targets in such a manner that the not-to-be-reached targets are three-dimensionally formed. Based on the dentist's instruction, the control apparatus <NUM> creates a three-dimensional image 120a of the not-to-be-reached targets as a third three-dimensional image (fourth surface data) <NUM>. The third three-dimensional image <NUM> includes a three-dimensional image 160a of the main pillar <NUM>. That is, the third three-dimensional image <NUM> includes a three-dimensional image 120a of a not-to-be-reached target and a three-dimensional image 160a of the main pillar <NUM>. Thus, specifying a target includes specifying a three-dimensional image 160a of the main pillar <NUM> joined to the second three-dimensional image <NUM> (image based on the first surface data). The three-dimensional image 160a of the main pillar <NUM> of the model <NUM> is formed by making a mark at a position that does not become an obstacle in the case where the dentist brings the distal end of the hole-forming instrument <NUM> close to the target model portion <NUM> through the opening portion <NUM>.

The three-dimensional image 160a of the main pillar <NUM> may be configured in such a manner that, after the three-dimensional image 100a of the model <NUM> is created, a three-dimensional image 160a of the main pillar <NUM> for the joining may be set to maintain the positional relationship between the three-dimensional image 110a of the model main body <NUM> and the three-dimensional image 120a of the target model portion <NUM>.

It is to be noted that, if, for example, the three-dimensional image 160a of the main pillar <NUM> is automatically created by, for example, the function of the 3D printer <NUM>, the specification of the three-dimensional image 160a may be eliminated.

Based on the dentist's instruction, the control apparatus <NUM> may specify, in the first three-dimensional image <NUM>, the position of a lingual-side surface (wall) of the inferior alveolar bone close to the not-to-be-reached targets such as the inferior alveolar artery and the inferior alveolar nerve. Based on the dentist's instruction, the control apparatus <NUM> may mark, on the screen of the display <NUM>, the position of the lingual-side surface as a not-to-be-reached target of the third three-dimensional image <NUM>.

Based on the dentist's instruction, the control apparatus <NUM> sets or installs, on the screen of the display <NUM>, the shape (e.g., the length and the outer diameter), the angle, the position, etc. of an implant body that models the implant body <NUM> at the treatment position, as shown in <FIG> (step S4). The term "installation" refers to importing three-dimensional data acquired by, for example, a dentist using a 3D scanner into the system <NUM>. The term "angle of the implant body" refers to, for example, the installation orientation relative to the treatment position of the patient.

It is to be noted that, for the implant body, three-dimensional image data corresponding one-to-one to the implant body and containing the same shape and the same dimensional information as that of the actual implant body <NUM> that has been actually medically approved is used. At this time, the dentist takes into consideration the relationship with the shapes of an abutment and an upper structure (crown part) to be attached to the implant body <NUM>. The dentist selects, for example, a single implant body that matches the settings from among a plurality of three-dimensional images 22a of implant bodies stored in the storage apparatus <NUM>. A fourth three-dimensional image (second surface data) <NUM> of the implant body selected by the dentist is provided by, for example, the manufacturer of the implant body <NUM>. The dentist may create the fourth three-dimensional image <NUM> of the implant body by himself/herself if such an image is not provided by the manufacturer of the implant body <NUM>. The control apparatus <NUM> causes the storage apparatus <NUM> to store the fourth three-dimensional image <NUM> of the implant body created by the dentist.

The dentist can select the implant body <NUM> by himself/herself, and set the angle, the position, etc. of the implant body <NUM> relative to the bone of the lower jaw to be optimum according to the patient. At this time, it is easy for the dentist to select the implant body again and test fitness of implant bodies with different lengths and outer diameters on the treatment objective site of the patient.

Based on the dentist's instruction, the control apparatus <NUM> selects, from among a plurality of drill sets of one or more manufacturers used for patients' treatment, an appropriate hole-forming instrument according to the depth, the diameter, the angle, and the position of the recessed opening <NUM> for embedding the selected implant body, as shown in <FIG> (second processing). It is to be noted that, for the hole-forming instrument, a three-dimensional image corresponding one-to-one to the hole-forming instrument and containing information on the same shape and the same dimensions as those of the hole-forming instrument <NUM> that has been actually medically approved is used. The dentist may usually select a hole-forming instrument <NUM> recommended by the manufacturer of the selected implant body <NUM>; however, a hole-forming instrument <NUM> of a manufacturer other than the manufacturer of the selected implant body <NUM> may be used. Based on the dentist's instruction, the control apparatus <NUM> selects a single hole-forming instrument <NUM> that matches the settings from a plurality of three-dimensional images 22b of the hole-forming instrument that models the hole-forming instrument <NUM> stored in the storage apparatus <NUM>. A fifth three-dimensional image (third surface data) <NUM> of the hole-forming instrument <NUM> selected by the control apparatus <NUM> is provided by, for example, the manufacturer of the hole-forming instrument <NUM>. If the fifth three-dimensional image <NUM> is not provided by the manufacturer of the hole-forming instrument <NUM>, the dentist may create the fifth three-dimensional image <NUM> by himself/herself. The control apparatus <NUM> causes the storage apparatus <NUM> to store the fifth three-dimensional image <NUM> created by the dentist.

It is to be noted that, in general, the diameter of the opening portion <NUM> formed by the actual hole-forming instrument <NUM> is slightly smaller than the outer diameter of the actual implant body <NUM>. Such a relationship remains the same on the screen of the display <NUM>. A difference in outer diameter between the hole-forming instrument and the implant body can be suitably set as a parameter input by the dentist to the operation portion <NUM>.

Based on the dentist's instruction, the control apparatus <NUM> aligns, on the software-based screen of the display <NUM>, coordinate axes of the first to fifth three-dimensional images <NUM>-<NUM>, and superimposes the second three-dimensional image (e.g., STL data) <NUM> on the first three-dimensional image (e.g., DICOM data) <NUM>, the third three-dimensional image <NUM>, the fourth three-dimensional image <NUM>, and/or the fifth three-dimensional image <NUM>, in a predetermined coordinate system in which the coordinate axes are aligned (step S5). At this time, the dentist finds, for example, points of identity in size and shape, such as the alignment of teeth, and performs matching between the first three-dimensional image <NUM> and the second three-dimensional image <NUM>. Such matching may be performed automatically by the control apparatus <NUM> using software. The first three-dimensional image <NUM> includes a third three-dimensional image <NUM>, a fourth three-dimensional image <NUM>, and/or a fifth three-dimensional image <NUM>. Thus, the control apparatus <NUM> may clearly show the positional relationship between the surface of the teeth and the gums of the lower jaw (the second three-dimensional image <NUM>) and the arteries and the nerves of the inside of the alveolar bone (the third three-dimensional image <NUM>) on the display <NUM>, as shown in <FIG>, using software. Thus, the control apparatus <NUM> may clearly show the positional relationship among the surface of the teeth and the gums of the lower jaw, the alveolar bone, the not-to-be-reached targets, the implant body, and the hole-forming instrument to the dentist using software.

Based on the dentist's instruction, the control apparatus <NUM> creates, on the software-based screen of the display <NUM>, a three-dimensional image of the adjunctive instrument (surgical template) in accordance with the shape of the lower jaw of the patient, as shown in <FIG> (step S6). That is, the control apparatus <NUM> creates image data of the adjunctive instrument as a sixth three-dimensional image <NUM>.

The adjunctive instrument <NUM> shown in <FIG> guides the body <NUM> of the hole-forming instrument <NUM> along the treatment portion, while covering a portion of the surface of the gum. In determining a treatment plan based on the dentist's instruction, the control apparatus <NUM> outputs a three-dimensional image (e.g., STL data) for the 3D printer <NUM> or the milling machine <NUM> of the adjunctive instrument <NUM>, and causes the 3D printer <NUM> or the milling machine <NUM> to construct the adjunctive instrument <NUM>. The adjunctive instrument <NUM> can be fit into or engages with the model <NUM> (see <FIG>) created by the 3D printer <NUM>. It is to be noted that a resin material used for the adjunctive instrument <NUM> differs according to whether or not the adjunctive instrument <NUM> is actually used during a treatment. If a medically approved resin material is used as the adjunctive instrument <NUM>, the adjunctive instrument <NUM> can be used as it is. If a medically non-approved resin material is used as the adjunctive instrument <NUM>, the adjunctive instrument <NUM> cannot used for an actual treatment as it is. In this case, the adjunctive instrument <NUM> fit into the model <NUM> may be used for pre-procedure verification of a created treatment plan to confirm, for example, that the distal end of the hole-forming instrument <NUM> is placed at a predetermined position, and that the target model portion <NUM> is not contacted.

In actual procedures, the dentist cannot confirm how many millimeters have been dug from the surface of the gums (not the alveolar bone) during formation of a recessed opening in the treatment objective site of the patient. However, the dentist can confirm in advance how many millimeters have been dug from the surface of the alveolar bone, and a distance from the surface of the alveolar bone to the artery, using tools to be actually used.

<FIG> show a schematic diagram of the lower jaw <NUM>, including the alveolar bone <NUM>, the teeth <NUM>, the gums <NUM>, the recessed opening <NUM>, and the not-to-be-reached targets <NUM> including the inferior alveolar artery and the inferior alveolar nerve.

As shown in <FIG>, in an actual implant treatment, the dentist forms the recessed opening <NUM> in the inferior alveolar bone <NUM> and the gums <NUM> using, for example, the adjunctive instrument <NUM> and the hole-forming instrument <NUM>. The recessed opening <NUM> has a depth equal to the sum of a distance D1 from a top of the inferior alveolar bone <NUM> to a bottom of the recessed opening <NUM> and a distance (offset value) D2 from a top (defining surface) <NUM> of the inferior alveolar bone <NUM> to a defining surface <NUM> of the adjunctive instrument <NUM>. That is, in the case of using the adjunctive instrument <NUM>, the depth of the recessed opening <NUM> is offset from the top of the inferior alveolar bone <NUM> to the defining surface <NUM> of the adjunctive instrument <NUM>.

In this case, as shown in <FIG>, the dentist selects the hole-forming instrument <NUM> and the implant body <NUM> in such a manner that (length H1 of drill body <NUM> below upper end 46b of drill sleeve <NUM>)-(height H2 of stopper <NUM>)=(length D1 of implant body <NUM> used during surgery)+(offset value D2 during use of adjunctive instrument <NUM>) is satisfied. The dentist forms the recessed opening <NUM> in such a manner that a bottom of the recessed opening <NUM> or a bottom of the implant body <NUM> and the not-to-be-reached targets <NUM> are separated from each other, and embeds the implant body <NUM> into the recessed opening <NUM>. That is, the dentist suitably inputs the above-described parameters H1, H2, D1, and D2 through the use of the operation portion <NUM>, using the shape (e.g., outer diameter), the position, and the angle of the implant body <NUM> or the inner diameter, the position, and the angle of the recessed opening <NUM> as parameters, and creates an optimum treatment plan while confirming the state relative to the treatment objective site of the patient. The setting or installation of the parameters H1 and H2 includes selection of an optimum hole-forming instrument <NUM> by the dentist.

Based on the dentist's instruction, the control apparatus <NUM> superimposes, on a predetermined coordinate system, the first three-dimensional image <NUM> of the bone of the lower jaw, the second three-dimensional image <NUM> of the surface of the teeth and the gum, the third three-dimensional image <NUM> of the not-to-be-reached targets, the fourth three-dimensional image <NUM> of the implant body, and/or the fifth three-dimensional image <NUM> of the hole-forming instrument, and the sixth three-dimensional image <NUM> of the adjunctive instrument, as shown in <FIG> (step S7, fifth process). The dentist confirms, on the display <NUM>, a state of placement of, for example, the sixth three-dimensional image <NUM>, the fourth three-dimensional image <NUM> or the fifth three-dimensional image <NUM>, and the third three-dimensional image <NUM>, as shown in <FIG>. That is, the control apparatus <NUM> clearly shows, on the software-based screen of the display <NUM>, a positional relationship between the adjunctive instrument, the implant body, the hole-forming instrument for forming an opening for embedding an implant body, and the not-to-be-reached targets to the dentist.

It is to be noted that the control apparatus <NUM> performs the processing from step S3 to step S7 using the image processing program, and causes the display <NUM> to perform display using the image display program.

The control apparatus <NUM> constructs the adjunctive instrument <NUM> by means of the 3D printer <NUM> or the milling machine <NUM> (step S8).

The dentist confirms whether or not there is any problem that should be fixed in the treatment plan on the software-based screen of the display <NUM> of the control apparatus <NUM>. If there is any problem, the problem is fixed. If there is no problem, based on the dentist's instruction, the control apparatus <NUM> superimposes, on a predetermined coordinate system, the second three-dimensional image <NUM>, the third three-dimensional image <NUM>, the fourth three-dimensional image <NUM>, and the fifth three-dimensional image <NUM> (step S9), as shown in <FIG>. In the second three-dimensional image <NUM>, by deleting an image portion of a site opposite to the defining surface <NUM> or the teeth of the surface of the gums, bordered by a suitable plane 52a, for example, the lingual-side and cheek-side walls are removed, with the gums surface including the defining surface <NUM> of the teeth-side gums and the teeth maintained. It is to be noted that, depending on the second three-dimensional image <NUM> that can be obtained by the second scanner <NUM>, partial deletion of the image bordered by the plane 52a can be eliminated.

At this time, based on the dentist's instruction, the control apparatus <NUM> superimposes, on a predetermined coordinate system on the screen of the display <NUM>, the second three-dimensional image <NUM>, the third three-dimensional image <NUM>, the fourth three-dimensional image <NUM>, and the fifth three-dimensional image <NUM> by means of software that creates a treatment plan. Alternatively, if the three-dimensional images are of compatible data types, the control apparatus <NUM> may, based on the dentist's instruction, import the three-dimensional images into, for example, 3D CAD software different from the software that creates the treatment plan, and superimpose the three-dimensional images. At this time, the control apparatus <NUM> imports only an image (sleeve-related fifth three-dimensional image) 55a of a portion that does not include a body and a shank assumed to be used for procedures, for example, a sleeve (guide tube), of the fifth three-dimensional image <NUM> of the hole-forming instrument.

Based on the dentist's instruction, the control apparatus <NUM> removes, on the software, the fourth three-dimensional image <NUM> relating to the implant body and the fifth three-dimensional image 55a relating to the sleeve (step S10, third process), as shown in <FIG>. That is, the control apparatus <NUM> creates, on the software-based screen of the display <NUM>, a three-dimensional image (fifth surface data) 100a of the model <NUM> including a three-dimensional image 110a of the model main body <NUM> including a through opening 130a that models a recessed opening for embedding a tooth or an implant body, and a three-dimensional image 120a of the target model portion <NUM> for the 3D printer <NUM>.

It is preferable that a three-dimensional image corresponding to the support (the base portion <NUM> and the pillars (sub-pillars) <NUM>) be automatically created using the function of the 3D printer <NUM>.

The control apparatus <NUM> performs the processing from step S9 to step S10 using the image processing program, and causes the display <NUM> to perform display using the image display program.

The dentist confirms the three-dimensional image 100a of the model <NUM>, which is data for the 3D printer <NUM>. After that, the control apparatus <NUM> outputs the three-dimensional image (fifth surface data) 100a of the model <NUM> to, for example, the 3D printer <NUM>. That is, the dentist constructs, under an operation input instruction to the operation portion <NUM>, the model <NUM> (see <FIG>) (step S11, fourth process) of the treatment site of the patient including a target model portion <NUM> that models the inferior alveolar artery and the gums including a through opening <NUM> that models a recessed opening <NUM> for embedding a tooth or the implant body <NUM> with the 3D printer <NUM> controlled by the control apparatus <NUM> (step S11, fourth process).

Here, the dentist temporarily ends the treatment plan creation process using the system <NUM>.

In this manner, the operation portion <NUM> of the above-described system <NUM> gives, to the control apparatus <NUM>, a processing instruction to specify a treatment objective site of the patient and not-to-be-reached targets in a three-dimensional stereo image of the patient, and a processing instruction to set an opening that models a recessed opening for embedding an implant body to be embedded in the treatment objective site by setting a variety of parameters of the implant body or installing data acquired by the dentist using a 3D scanner, etc. in a three-dimensional stereo image of the patient. Also, the operation portion <NUM> inputs, to the control apparatus <NUM>, a processing instruction (coordinate conversion instruction) to superimpose first surface data (surface-image-related data), second surface data or third surface data, and fourth surface data on a predetermined coordinate system, and a processing instruction to create fifth surface data indicating a positional relationship between the fourth surface data and a treatment objective site including an opening by subtracting the second surface data and the third surface data from the first surface data.

That is, the operation portion <NUM> inputs, to the control apparatus <NUM>, a processing instruction (coordinate conversion instruction) to superimpose the first surface data, at least one of the second surface data and the third surface data, and the fourth surface data on a predetermined coordinate system, and a processing instruction to create fifth surface data indicating a positional relationship between the fourth surface data and a treatment objective site including an opening by subtracting the second surface data and the third surface data from the first surface data, and the control apparatus <NUM> performs the instructed processing. It is to be noted that, if the second surface data is not used in the coordinate conversion instruction, the second surface data need not be subtracted during the creation of the fifth surface data. If third surface data is not used in the coordinate conversion instruction, the third surface data need not be subtracted during the creation of the fifth surface data.

The dentist fits, for example, an adjunctive instrument <NUM> suitable for the hole-forming instrument <NUM> and the shape of the gums of the treatment objective site of the patient into the model <NUM> constructed by the 3D printer <NUM>, as shown in <FIG>. Furthermore, the dentist inserts the body <NUM> of the hole-forming instrument <NUM> into the guide opening <NUM> of the adjunctive instrument <NUM>. At this time, the hole-forming instrument <NUM> uses the sleeve <NUM> and the stopper <NUM> in a manner similar to the actual procedures. The dentist visually confirms the positional relationship between the distal end of the body <NUM> of the hole-forming instrument <NUM> and the target model portion <NUM>. Specifically, upon insertion of the hole-forming instrument <NUM>, fit into the guide opening <NUM> of the adjunctive instrument <NUM>, into the through opening <NUM> to bore a recessed opening for embedding the implant body <NUM> with the body <NUM> of the hole-forming instrument <NUM>, the dentist confirms whether or not the body <NUM> of the hole-forming instrument <NUM> faces a desired direction, or the distal end of the body <NUM> maintains a state of being separated from the target model portion <NUM> of the arteries, the nerves, and the like.

It is to be noted that the dentist, etc. removes the foundation <NUM> and the pillars <NUM> from the model <NUM> as necessary, to confirm the state of visual recognition of the distal end of the body <NUM> of the hole-forming instrument <NUM>.

The dentist confirms a range within which the distal end of the body <NUM> of the hole-forming instrument <NUM> can move. During the hole formation by the hole-forming instrument <NUM>, the distal end of the body <NUM> of the hole-forming instrument <NUM> is moved so as not to break the lingual-side wall of the alveolar bone. Thus, the dentist confirms that the distal end of the body <NUM> of the hole-forming instrument <NUM> does not touch a membranous body 145b, which is the lingual-side wall of the model <NUM>.

In an actual treatment, it is recommended to make the distal end of the body <NUM> of the hole-forming instrument <NUM> separate from the inferior alveolar nerve and the inferior alveolar artery by <NUM> or greater. Thus, a treatment plan may be created in such a manner that the target model portion <NUM> of each of the inferior alveolar nerve and the inferior alveolar artery is created so as to be greater than the actual one toward the defining surface <NUM> by, for example, <NUM> or greater, and that the distal end of the hole-forming instrument <NUM> abuts thereto. That is, by making a part of the target model portion <NUM> closer to the side of the defining surface <NUM> than the positions of the actual not-to-be-reached targets, the dentist can judge whether or not it is possible to use the hole-forming instrument <NUM> actually used for the patient, based on a positional relationship between the position at which the distal end of the body <NUM> of the hole-forming instrument <NUM> abuts the target model portion <NUM> and the end surface 48a on the side of the body <NUM> of the stopper <NUM> of the hole-forming instrument <NUM>. That is, the dentist can also form, for example, the target model portion <NUM> as a to-be-reached (to-be-contacted) target, not as a not-to-be-reached (not-to-be-contacted) target.

In this manner, the dentist can perform advance verification of the procedure of creating a recessed opening in which the implant body <NUM> is to be embedded, using the hole-forming instrument <NUM> that is actually used, by constructing, using the system <NUM>, a model <NUM> of the same size and shape as those of the actual patient, using the three-dimensional images <NUM> and <NUM> of the patient and the three-dimensional images <NUM> and <NUM> of the implant body and the hole-forming instrument. If there is no problem in the advance verification, the dentist performs procedures on the actual patient in accordance with the treatment plan. If a problem arises in the advance verification, the dentist fixes the treatment plan as necessary, re-creates the model <NUM> and the adjunctive instrument <NUM>, and performs advance verification of the procedures. The dentist repeats the operation as necessary until there is no problem in advance verification.

It is to be noted that, in the case of constructing the model <NUM>, the dentist may selectively use the three-dimensional images <NUM> and <NUM> of the implant body and the hole-forming instrument.

The position, size, angle, etc. of the through opening <NUM> of the model main body <NUM> are formed to have a final size for fitting the implant body <NUM>. In actual procedures, the dentist digs the hole, which is originally small, to gradually increase the diameter and the depth of the hole. Thus, in formation of a recessed opening in actual procedures, the dentist advances the procedure by gradually changing the length and the diameter of the drill body <NUM> from smallest to largest. In the system <NUM>, it is possible to describe what specific hole-forming instrument is used by the dentist to form a recessed opening as a treatment plan; however, in a three-dimensional image constructed by the 3D printer <NUM>, a recessed opening of a final size that allows the implant body <NUM> to be embedded therein may be set.

By using a plurality of models <NUM> that fit the sizes and shapes of the respective drill bodies <NUM>, the dentist can perform advance verification to advance procedures using the model <NUM> constructed by making the size of the through opening <NUM> conform to the drill diameter by gradually changing the drill length and diameter from smallest to largest. That is, by using the model <NUM>, it is possible to perform advance verification of a variety of procedural instruments used in creation of the recessed opening, as well as the hole-forming instrument <NUM> that is finally used. Examples of the procedural instrument used during creation of the recessed opening include an injection instrument which injects a bone graft material, fibrin gel containing platelet, etc. separated from the withdrawn blood, or a mixture thereof into the treatment objective site.

At present, the dentist may perform actual procedures by calculating various parameters such as the length of the body <NUM>, the height of the stopper <NUM>, and offset values of the hole-forming instrument during the procedures in accordance with the implant body <NUM> to be used. If the dentist makes an error in any one of the parameters, an instrument different from the instrument that should be originally used might be used, possibly leading to a medical accident. By using the model <NUM> according to the present embodiment, the dentist himself/herself can perform advance verification as to the validity of the use of each procedural instrument in actual procedures until a final-size recessed opening is formed.

Also, the creator of the treatment plan in the system <NUM>, such as a dentist, may make an error in various parameters such as the length of the body <NUM>, the height of the stopper <NUM>, and offset values of the hole-forming instrument <NUM> during creation of the treatment plan. There may be a case where the creator of the treatment plan misses an error in the parameters and ends the creation of the treatment plan. Even in such a case, by performing advance verification of a treatment plan using the model <NUM> and the actual hole-forming instrument <NUM>, the dentist can notice setting faults in the parameters in the treatment plan. The dentist can discuss, using the model <NUM>, how the parameters such as the length of the body <NUM>, the height of the stopper <NUM>, and offset values of the hole-forming instrument <NUM> to be used should be changed to perform the procedures successfully. In this case, a hole-forming instrument other than the hole-forming instrument <NUM> of the manufacturer set during the creation of the treatment plan can be suitably tried. Thus, by using the model <NUM>, the dentist can appropriately select the hole-forming instrument <NUM> from among, for example, a plurality of instruments that the dentist owns.

Accordingly, advance verification of procedures by the dentist using the model <NUM>, as described in the present embodiment, should be performed as an integral part of an implant treatment. Thus, through advance verification of procedures using the model <NUM>, the dentist can appropriately change the hole-forming instrument <NUM> as necessary, and perform an optimum treatment. It is to be noted that the dentist may fix the treatment plan using the system <NUM>, as a matter of course. Thus, through the use of the model <NUM> according to the present embodiment by the dentist, it is possible to greatly increase the safety of the implant treatment.

In an implant treatment, the dentist creates, for example, the adjunctive instrument <NUM>, creates a recessed opening of a predetermined size at a desired position of the lower jaw of the patient, and embeds the implant body <NUM> into the recessed opening. Conventionally, due to the relationship between the hole-forming instrument <NUM> and the adjunctive instrument <NUM> for embedding the implant body <NUM>, there has been no means for the dentist to visually and actually confirm, prior to procedures, whether or not a distal end of the body <NUM> of the hole-forming instrument <NUM> reaches the not-to-be-reached targets if an alternative hole-forming instrument of another manufacturer is selected based on the dentist's own idea. According to the present embodiment, the dentist can verify, prior to procedures, the relationship between a model main body <NUM> including the treatment objective site of the patient, the target model portion <NUM>, the adjunctive instrument <NUM>, and the hole-forming instrument <NUM> or the implant body <NUM>, using the model <NUM> and the actual hole-forming instrument <NUM> or the implant body <NUM>. That is, the dentist can perform advance verification of the created treatment plan prior to the actual procedures. This allows the dentist to perform actual procedures by performing advance verification of the safety of procedures with the hole-forming instrument <NUM>. Since the dentist grasps in advance the distal end reaching position of the body <NUM> of the hole-forming instrument <NUM> relative to the not-to-be-reached targets, namely, a separation distance or an abutment state between the not-to-be-reached targets and the distal end of the body <NUM> of the hole-forming instrument <NUM> in the model <NUM>, it is possible, in actual procedures, for the dentist to shorten the time required for the procedures. This allows the dentist to perform minimally invasive procedures on the patient by performing procedures in accordance with the treatment plan.

The dentist can perform a treatment plan creation process using the system <NUM> between a medical action of acquiring patient data using a first scanner (CT scanner) <NUM> and a second scanner (intraoral scanner) <NUM> and a medical action of actually performing procedures on the patient. In the present embodiment, an example has been described in which the dentist creates a treatment plan by himself/herself. The treatment plan creation process is an extremely important process leading to a medical action of performing procedures to embed the implant body <NUM> into the lower jaw, even though actual treatment and diagnosis of the patient is not performed. Thus, the process of creating, by the dentist, a treatment plan using the system <NUM> and performing advance verification of procedures using the model <NUM> created based on the treatment plan and the adjunctive instrument <NUM> is extremely effective for ensuring safety of the implant treatment. For that purpose, to ensure the safety of the treatment, it is extremely useful for the dentist himself/herself to use the system <NUM> configured to create an optimum treatment plan for each patient.

Since the creation of the treatment plan itself is not a direct medical action, as described above, there may be a case where a person who is unqualified for a dental treatment action such as a technician of the manufacturer or a dental mechanic creates a treatment plan. Even in such a case, the dentist can receive treatment plan creation data, and discuss a treatment plan and give a fixation instruction or perform fixation by himself/herself in the system <NUM>. In either case, the dentist can perform advance verification of the safety of the treatment using the model <NUM>, the hole-forming instrument <NUM>, the implant body <NUM>, and the adjunctive instrument <NUM> immediately before performing the actual procedures.

In the case of fixing the above-described treatment plan and re-creating the model <NUM>, it is possible to reduce the time for correspondence with the professional such as the manufacturer by the dentist himself/herself performing a series of operations using the system <NUM>. Thus, in the case where the dentist creates a treatment plan and outputs the model <NUM> with the 3D printer <NUM>, it is possible to greatly reduce the time, for example, in units of weeks, compared to the case where the professional is used. Accordingly, the dentist can arrange a state in which procedures on the patient can be performed at an earlier stage.

In the case where the dentist uses the system <NUM>, the dentist can take the initiative in laying an optimum treatment plan by trial and errors. Thus, even if the output of the adjunctive instrument <NUM> and the model <NUM> is left to the professional, the number of fixations of the adjunctive instrument <NUM> and the model <NUM> can be reduced. Accordingly, the dentist can arrange a state of performing procedures on the patient at an earlier stage.

It is to be noted that, conventionally, an adjunctive instrument (a surgical guide) has not necessarily been required. Thus, it is hard to say that, in an implant treatment as of now, adjunctive instruments are in widespread use. By the dentist himself/herself designing the adjunctive instrument <NUM> using the system <NUM> according to the present embodiment and outputting it using, for example, the 3D printer <NUM> or the milling machine <NUM> owned by the dentist himself/herself, it is possible to greatly reduce the expense for creation of the adjunctive instrument <NUM>. Accordingly, by using the system <NUM> according to the present embodiment, it is possible to spread the use of adjunctive instruments such as a surgical guide across dentists during an implant treatment.

Accordingly, by using the system <NUM>, it is possible to allow the dentist to take the initiative in creating a treatment plan as much as possible, thus reducing the cost for creating a treatment plan including the adjunctive instrument <NUM> and disseminating treatment with higher safety using the adjunctive instrument <NUM>.

As described above, according to the present embodiment, it is possible to provide a pre-procedure verification system <NUM> of a dental treatment plan, a pre-procedure verification program of the dental treatment plan, a method of manufacturing a model <NUM> for pre-procedure verification of the dental treatment plan, and the model <NUM> for the pre-procedure verification of the dental treatment plan, which allow the dentist to perform, in performing a treatment of embedding an embedded body such as an implant body, advance verification of the positional relationship between the position of a distal end of a procedural instrument during use of the procedural instrument and target positions such as the positions of the inferior alveolar artery and the inferior alveolar nerve of the lower jaw of the patient, prior to a dental treatment using an actual procedural instrument such as a hole-forming instrument <NUM>.

It is to be noted that, if the adjunctive instrument is not used, the hole-forming instrument <NUM> is inserted into the opening portion <NUM> of the model <NUM> constructed by the 3D printer <NUM>, as shown in <FIG>. The model <NUM> is formed in such a manner that the end surface 48a on the side of the body <NUM> of the stopper <NUM> abuts the defining surface <NUM> of the model main body <NUM>. The dentist confirms the range within which the distal end of the body <NUM> of the hole-forming instrument <NUM> can move, and visually confirms the positional relationship between the distal end of the body <NUM> of the hole-forming instrument <NUM> and the target model portion <NUM>. Specifically, the dentist confirms, upon insertion of the body <NUM> of the hole-forming instrument <NUM> into the through opening <NUM> to bore a recessed opening for embedding the implant body <NUM>, whether or not the body <NUM> of the hole-forming instrument <NUM> faces a desired direction, and whether or not the distal end of the body <NUM> maintains a state of separation from the target model portion <NUM> of the arteries, the nerves, etc..

In the model <NUM> shown in <FIG>, there is no site corresponding to the inferior alveolar bone of the patient. There may be a site corresponding to the inferior alveolar bone as membranous bodies 145a and 145b that allows the dentist to visually recognize the target model portion <NUM>, with the resin material of the model <NUM> created by the 3D printer <NUM> being, for example, transparent or semitransparent, as shown in <FIG>. The membranous body 145a models the cheek-side or lip-side wall of the alveolar bone. The membranous body 145a models the lingual-side wall of the alveolar bone. At this time, it is preferable that the distal end of the body <NUM> of the hole-forming instrument <NUM> not touch the lingual-side membranous body 145b. It is preferable that a surface of the lingual-side membranous body 145b on the side of the target model portion <NUM> be formed at a position corresponding to the lingual-side surface of the actual alveolar bone of the patient. If the model <NUM> is not that of the lower jaw but the upper jaw of the patient, the lingual-side surface corresponds to the palatine-side surface of the actual alveolar bone of the patient. If the resin material of the model <NUM> is, for example, transparent or semitransparent, the model <NUM> is formed in a state in which the fourth three-dimensional image <NUM> of the implant body and the fifth three-dimensional image <NUM> of the hole-forming instrument have been removed from the left lower diagram in <FIG>. The site corresponding to the inferior alveolar bone may be formed in a mesh shape if the positional relationship between the hole-forming instrument <NUM> and the target model portion <NUM> can be visually recognized.

The adjunctive instrument <NUM> includes a guide opening <NUM> for forming a recessed opening for embedding the implant body <NUM>. If the guide opening <NUM> and the recessed opening <NUM> are formed by a rotating drill used as the hole-forming instrument <NUM>, they are formed as circular openings. There may be a case where non-circular openings may be formed, as the guide opening <NUM> and the recessed opening <NUM>, by a hole-forming instrument <NUM> that is other than a rotating drill.

In the present embodiment, an example has been described in which two scanners, namely, the first scanner <NUM> and the second scanner <NUM>, are used. If, for example, the first three-dimensional image <NUM> and the second three-dimensional image <NUM> can be acquired by a single scanner, the provision of a plurality of scanners may be eliminated.

The first scanner <NUM> and the second scanner <NUM> are owned by, for example, a dentist, and the dentist acquires a three-dimensional image of the jaw of the patient. The formation of the construction by the 3D printer <NUM> may be performed by a suitable professional. Since a three-dimensional image of the patient may be acquired using, for example, the first scanner <NUM> and/or the second scanner <NUM>, it is also preferable that the first scanner <NUM> and/or the second scanner <NUM> not be included in the system <NUM>. It is also preferable that the 3D printer <NUM> and/or the milling machine <NUM> not be included in the system <NUM>.

In the present embodiment, an example has been described in which the adjunctive instrument <NUM> is created in the system <NUM>, and the adjunctive instrument <NUM> is used in actual procedures. There may be a case where the adjunctive instrument <NUM> is not necessarily required through selection of, for example, the hole-forming instrument <NUM>. A treatment plan may be laid in such a manner that the hole-forming instrument <NUM> including the drill body <NUM> and the sleeve <NUM> is placed through the opening <NUM>, as shown in <FIG>, instead of placing the adjunctive instrument <NUM> in the model <NUM>.

In the system <NUM> according to the first embodiment, an example has been described in which matching is performed between a CT image (first three-dimensional image) of the lower jaw of the patient and a three-dimensional image (a second three-dimensional image <NUM>) of the lower jaw of the patient, as shown in the left diagram in <FIG>.

A metal material, for example, may be used as part of the patient's teeth. Due to, for example, noise called artifacts, it is sometimes difficult to obtain a vivid CT image of the patient (first three-dimensional image <NUM>). In this case, it is preferable that, based on the dentist's instruction, the control apparatus <NUM> allow the first three-dimensional image <NUM> and the second three-dimensional image <NUM> to be placed so as to be shifted from each other, while finding points of identity in shape such as the alignment of teeth.

For example, based on the dentist's instruction, the control apparatus <NUM> superimposes, in the software on the display <NUM>, the second three-dimensional image <NUM> on the first three-dimensional image <NUM> on which the third to fifth three-dimensional images <NUM>-<NUM> are superimposed, so as to be shifted from the first three-dimensional image <NUM>, as shown in the right diagram in <FIG>, beginning at the state shown in the left diagram in <FIG>. Specifically, the surface of the gums in the second three-dimensional image <NUM> is, for example, made to match the surface of the alveolar bone, or placed in the alveolar bone in the first three-dimensional image <NUM>. At this time, in the image (see the upper left diagram in <FIG>) obtained by subtracting the first three-dimensional image <NUM> from the image obtained by superimposing the second to fifth three-dimensional images <NUM>-<NUM>, a distance between the surface of the gums in the second three-dimensional image <NUM> and the not-to-be-reached targets in the third three-dimensional image <NUM> is shorter than a distance from the surface of the actual gums of the patient to the not-to-be-reached targets. Thus, the dentist uses, in actual procedures, a hole-forming instrument <NUM> with a length smaller than the actually usable one, and the fourth three-dimensional image <NUM> corresponding to the implant body is placed at a depth smaller than an actually embeddable position, relative to the third three-dimensional image <NUM>. Accordingly, the dentist can plan a treatment plan on the safer side.

If there is unreliability in matching between the first three-dimensional image <NUM> and the second three-dimensional image <NUM>, the second three-dimensional image <NUM> is caused to be close to the third three-dimensional image <NUM> within a realistic range. Thus, by planning the implant position in such a manner that the distance between the second three-dimensional image <NUM> and the third three-dimensional image <NUM> is equal to or shorter than the actual distance, it is possible to ensure safety. In an actual treatment, based on the dentist's instruction, the control apparatus <NUM> sets a new second three-dimensional image <NUM> (first surface data) by shifting characteristic points of the second three-dimensional image <NUM> (a three-dimensional image of the surface) to the side of an image (target) based on the third three-dimensional image <NUM> (fourth surface data).

By the way, separating the surface of the gums of the second three-dimensional image <NUM> from the first three-dimensional image <NUM> and the third three-dimensional image <NUM>, contrary to the example shown in the right diagram in <FIG>, could result in laying a treatment plan on a risky side. In the image (see the upper left diagram in <FIG>) obtained by subtracting the first three-dimensional image <NUM> from the image obtained by superimposing the second to fifth three-dimensional images <NUM>-<NUM>, a distance between the surface of the gums in the second three-dimensional image <NUM> and the not-to-be-reached targets in the third three-dimensional image <NUM> is greater than a distance from the surface of the actual gums of the patient to the not-to-be-reached targets. Thus, the dentist may have a mistaken idea that the implant body <NUM> and the hole-forming instrument <NUM> may be, for example, placed at a greater depth and set to have a greater length in actual procedures. This may result in the dentist planning a treatment plan on a more risky side.

The system <NUM> according to the second modification of the first embodiment will be described with reference to <FIG>. Herein, a difference in parameter settings in the case of using a hole-forming instrument <NUM> different from the hole-forming instrument <NUM> shown in <FIG> will be described.

<FIG> shows a first modification of the hole-forming instrument <NUM> different from that of <FIG>. The hole-forming instrument <NUM> shown in <FIG> includes a handle <NUM> in addition to the body <NUM>, the shank <NUM>, the sleeve <NUM>, and the stopper <NUM>. A lower end of the stopper <NUM> abuts the handle <NUM>. Thus, the position of the distal end of the body <NUM> of the hole-forming instrument <NUM> is adjusted by the height of the handle <NUM>. If, for example, the height of the handle <NUM> increases, a bottom of the recessed opening <NUM> is distanced from the not-to-be-reached target <NUM>.

As shown in <FIG>, the dentist selects the hole-forming instrument <NUM> and the implant body <NUM> in such a manner that (length D1 of implant body <NUM>)+(offset value D2 during use of adjunctive instrument <NUM>)=(length H1 of drill body <NUM> from upper end of drill sleeve <NUM>)-(height H2 of stopper <NUM>)-(height H3 of handle <NUM>). Based on the dentist's instruction, the control apparatus <NUM> sets various setting values in accordance with various hole-forming instruments <NUM>.

That is, the dentist suitably inputs the above-described parameters H1, H2, H3, D1, and D2 using the operation portion <NUM>, using the shape (length and outer diameter), the position, and the angle of the implant body <NUM> as parameters, and creates an optimum treatment plan while confirming the state relative to the treatment objective site of the patient. The setting or installation of the parameters H1, H2, and H3 may include selecting, by the dentist, an optimum hole-forming instrument <NUM>.

In the first embodiment, an example has been described with respect to the case where, as shown in <FIG>, the implant body <NUM> is embedded in the recessed opening <NUM> formed in the lower jaw. In the case of, for example, forming a recessed opening in which an autologous tooth <NUM> is embedded as an embedded body, as shown in <FIG>, instead of embedding the implant body <NUM> into the recessed opening <NUM>, it is possible to create a treatment plan using the system <NUM> described in the first embodiment.

The dentist can create a three-dimensional image (second surface data) of the autologous tooth <NUM>, similarly to the creation of the three-dimensional image of the implant body <NUM>. A three-dimensional image of the autologous tooth <NUM> may be acquired using various pieces of equipment. The three-dimensional image of the autologous tooth <NUM> may be acquired using, for example, the second scanner <NUM>.

Based on the dentist's instruction, the control apparatus <NUM> allows the above-described parameters H1, H2, H3, D1, and D2 to be suitably input using the operation portion <NUM>, using the shape, the position, and the angle of the autologous tooth <NUM> as parameters, and allows an optimum treatment plan to be created while allowing confirmation of the state relative to the treatment objective site of the patient. The setting or installation of the parameters H1, H2, and H3 may include selecting, by the dentist, an optimum hole-forming instrument <NUM>. The autologous tooth <NUM> has a shape that differs according to the patient, unlike the implant body <NUM>, for which a commercially available one may be used. Thus, in the case of embedding the autologous tooth <NUM> in the lower jaw, two or three recessed openings may be bored in accordance with the shape of the autologous tooth <NUM>. The adjunctive instrument <NUM> may also be used in the case of forming such recessed openings. In the case of creating a recessed opening, a plurality of hole-forming instruments 40a and 40b, which are either identical or different, may be used in order.

It is to be noted that, in performing regenerative medicine using, for example, the stem cells of the teeth instead of an autologous tooth, it is possible to perform a treatment of embedding the stem cells of the teeth cultured in vivo or ex vivo into a recessed opening. In this case, based on the dentist's instruction, the control apparatus <NUM> allows, in creation of a treatment plan in the system <NUM>, the above-described parameters H1, H2, H3, D1, and D2 to be suitably input using the operation portion <NUM>, using the shape, position, and angle of the cell tissues (e.g., an aggregate of cell tissues), which are an embedded body in regenerative medicine, as parameters, and allows an optimum treatment plan to be created, while allowing confirmation of the state relative to the treatment objective site of the patient. The setting or installation of the parameters H1, H2, and H3 may include selecting, by the dentist, an optimum hole-forming instrument <NUM>. In this manner, even in the case of performing regenerative medicine, it is possible for the dentist to create a treatment plan and to create a model for pre-procedure verification of a dental treatment plan using the above-described system <NUM>.

In the second embodiment, with reference to <FIG>, a case will be described where a system <NUM> is used in an example of performing an implant treatment in which an implant body <NUM> (see <FIG>), selected from a multitude, is embedded in the upper jaw of the patient. A description about the matters common to those described in the first embodiment will be suitably omitted.

The first scanner (dental CT scanner) <NUM> acquires a first three-dimensional image (e.g., DICOM data) <NUM> of the teeth, the bone, and the inside of the bone of the upper jaw of the patient, and outputs it to the control apparatus <NUM>. The control apparatus <NUM> causes the storage apparatus <NUM> to store the first three-dimensional image <NUM>. The second scanner (intraoral scanner) <NUM> acquires, for example, a second three-dimensional image (e.g., STL data) <NUM> of, for example, the surface of the teeth and the gums of the upper jaw of the patient, and outputs it to the control apparatus <NUM>. The control apparatus <NUM> causes the storage apparatus <NUM> to store the second three-dimensional image <NUM>.

As shown in <FIG>, the dentist specifies, on the software, the positions of the posterior superior alveolar artery and the greater palatine artery, which are not-to-be-reached targets, and the maxillary sinus floor mucosa (see <FIG>), using the first three-dimensional image <NUM> showing the superior alveolar bone, the maxillary sinus, the posterior superior alveolar artery, and the greater palatine artery obtained by the first scanner <NUM> at the time of setting of the recessed opening <NUM> for embedding the implant body. The dentist marks characteristic points of the not-to-be-reached targets in such a manner that the not-to-be-reached targets are three-dimensionally formed (step S3). The dentist creates not-to-be-reached targets as the third three-dimensional images 553a, 553b, and 553c. It is to be noted that the posterior superior alveolar artery, the greater palatine artery, and the maxillary sinus floor mucosa are adjacent to the superior alveolar bone.

In the right diagram in <FIG>, a three-dimensional image 553a of the site of the maxillary sinus 551a and the site of the posterior superior alveolar artery, and a three-dimensional image 553b of a site of the greater palatine artery are shown.

It is to be noted that the three-dimensional image 553c corresponding to the maxillary sinus floor mucosa may be created in a manner similar to a part of an egg shell, or may be formed in a sphere shape, for example, as a whole (see <FIG>). This is because, in performing advance verification of a treatment plan based on a model, it is a site corresponding to the maxillary sinus floor mucosa that affects the reaching of the distal end of the body <NUM> of the hole-forming instrument <NUM>, and the remaining site does not affect the reaching of the distal end of the body <NUM> of the hole-forming instrument <NUM>.

Based on the dentist's instruction, the control apparatus <NUM> sets or installs, on the software, the length, the outer diameter, the angle, the position, etc. of the implant body that models the implant body <NUM> at the treatment position, as shown in <FIG> (step S4). In this case, based on the dentist's instruction, the control apparatus <NUM> suitably sets the outer diameter, the position, and the angle of the implant body <NUM>, and a variety of parameters (including selection of the hole-forming instrument <NUM>) described in the first embodiment, and optimizes the treatment plan.

Based on the dentist's instruction, the control apparatus <NUM> aligns, on the software, coordinate axes of the first to fifth three-dimensional images <NUM>, <NUM>, 553a-553c, <NUM>, and <NUM>, as shown in <FIG>, and superimposes, on a predetermined coordinate system, the second three-dimensional image <NUM> on the first three-dimensional image <NUM>, the third three-dimensional images 553a-553c, the fourth three-dimensional image <NUM> and/or the fifth three-dimensional image <NUM> (step S5). Thus, the control apparatus <NUM> clearly shows, to the dentist, the positional relationship between the surface of the teeth and the gums of the upper jaw and the arteries inside the superior alveolar bone on the software.

Based on the dentist's instruction, the control apparatus <NUM> creates an adjunctive instrument (a surgical template) on the software in accordance with the shape of the upper jaw of the patient, as shown in <FIG> (step S6). That is, the control apparatus <NUM> creates an adjunctive instrument as a sixth three-dimensional image <NUM>. The dentist confirms, on the display <NUM>, a state of placement of the sixth three-dimensional image <NUM>, the fourth three-dimensional image <NUM> or the fifth three-dimensional image <NUM>, and the third three-dimensional images 553a and 553b (step S7). Based on the dentist's instruction, the control apparatus <NUM> outputs an adjunctive instrument (step S8).

The dentist confirms whether or not there is any problem that should be fixed in the treatment plan on the software. If there is any problem, the problem is fixed. If there is no problem, based on the dentist's instruction, the control apparatus <NUM> superimposes, on a predetermined coordinate system, the first three-dimensional image <NUM> showing the teeth and the superior alveolar bone, the second three-dimensional image <NUM> showing the teeth and the gums, the third three-dimensional images 553a and 553b of the not-to-be-reached targets, the fourth three-dimensional image <NUM> of the implant body, and the fifth three-dimensional image <NUM> of the hole-forming instrument <NUM>, as shown in <FIG> (step S9). At this time, the control apparatus <NUM> superimposes, on a predetermined coordinate system, the second three-dimensional image <NUM>, the third three-dimensional images 553a and 553b, the fourth three-dimensional image <NUM>, and the fifth three-dimensional image <NUM> by means of software same as the software that creates a treatment plan.

Based on the dentist's instruction, the control apparatus <NUM> removes, on the software, the fourth three-dimensional image <NUM> relating to the implant body <NUM> and the fifth three-dimensional image 55a relating to the sleeve (step S10). That is, the control apparatus <NUM> creates, on the software, data for the 3D printer <NUM> (surface data of the model) of the teeth, the gums including a through opening that models a recessed opening for embedding the implant body <NUM>, and the not-to-be-reached targets, as shown in <FIG>.

After the dentist has confirmed the data for the 3D printer <NUM>, based on the dentist's instruction input, the 3D printer <NUM> constructs, under the control of the control apparatus <NUM>, a model for the patient's treatment site that models the teeth, the gums including a through opening that models the recessed opening for embedding the implant body <NUM>, and the not-to-be-reached targets such as the posterior superior alveolar artery and the greater palatine artery (step S11).

<FIG> shows a relationship between the alveolar bone <NUM>, the teeth <NUM>, and the maxillary sinus <NUM> of the upper jaw <NUM>. <FIG> shows the implant body <NUM> being fixed to the upper jaw <NUM> using, for example, maxillary sinus floor augmentation such as a sinus lift (socket lift) treatment. There may be a case where the thickness of the superior alveolar bone <NUM> shown in <FIG> is inadequate for embedding the implant body <NUM> into the superior alveolar bone <NUM> of the upper jaw <NUM>. At this time, maxillary sinus floor augmentation is performed, in which the maxillary sinus floor mucosa 730a of the maxillary sinus <NUM> shown in <FIG> is lifted using an artificial bone graft material <NUM>. In the case of performing maxillary sinus floor augmentation, the maxillary sinus floor mucosa 730a of the maxillary sinus <NUM>, as well as the posterior superior alveolar bone artery and the greater palatine artery, becomes the not-to-be-reached target of the drill body <NUM>, which is the hole-forming instrument <NUM>.

In the case of performing maxillary sinus floor augmentation, the recessed opening <NUM> for embedding the implant body <NUM> is bored in the superior alveolar bone <NUM>. At this time, the recessed opening <NUM> is bored so as to reach the vicinity of the bottom of the maxillary sinus <NUM> but to not penetrate the maxillary sinus floor mucosa 730a. The superior alveolar bone <NUM> is penetrated not by the hole-forming instrument <NUM> but by an osteotome or the like. The bone graft material <NUM> is filled between the mucosa 730a of the maxillary sinus <NUM> and the superior alveolar bone <NUM>. The implant body <NUM> is embedded in this state. At this time, the bone graft material <NUM> and the implant body <NUM> do not break the maxillary sinus floor mucosa 730a.

In this case, as a model for pre-procedure verification of a dental treatment plan, a model that models the teeth, the gums, the posterior superior alveolar bone artery, the greater palatine artery, and the maxillary sinus floor mucosa is constructed, without forming the superior alveolar bone, as shown in <FIG>, similarly to, for example, the first embodiment in which the inferior alveolar bone is not formed. Such formation of the model allows the dentist to confirm the positional relationship between the distal end of the body <NUM> of the hole-forming instrument <NUM> and the maxillary sinus floor mucosa 730a, with the selected hole-forming instrument <NUM> fitted into the guide opening of the adjunctive instrument and the through opening of the model. That is, the dentist can perform advance verification of the dental treatment plan to verify whether or not a dental treatment can be performed in a safer manner.

It is preferable that the maxillary sinus floor mucosa 730a in the model of the upper jaw, with a site corresponding to the teeth and the gums formed as the model main body, be supported by one or more pillars, as in the model <NUM> described in the first embodiment.

In the case of using the system <NUM> in the upper jaw, similarly to the case of using the system <NUM> in the lower jaw, an advantageous effect similar to that in the lower jaw can be obtained.

As described above, according to the present embodiment, it is possible to provide a pre-procedure verification system <NUM> of a dental treatment plan, a pre-procedure verification program of a dental treatment plan, a method of manufacturing a model for pre-procedure verification of a dental treatment plan, and a model for pre-procedure verification of a dental treatment plan, which allow the dentist to perform advance verification of the positional relationship between the position of a distal end of a procedural instrument during use of the procedural instrument and the target positions such as the positions of the posterior superior alveolar artery and the greater palatine artery, and the maxillary sinus mucosa of the upper jaw of the patient, prior to, for example, a dental treatment using an actual procedural instrument in performing a treatment of embedding an embedded body such as an implant body.

It is to be noted that, in the system <NUM> according to the second embodiment, the autologous tooth <NUM> or cell tissues described in the modification of the first embodiment can be used, instead of the implant body <NUM>.

An example of using the upper jaw as shown in <FIG> will be described. An operation will be described in which the dentist has judged that an implant treatment is possible (step S2-Yes in the flow shown in <FIG>). It is to be noted that, in <FIG>, illustration of an image corresponding to the third three-dimensional image <NUM> showing the target of the three-dimensional image 100a of the model <NUM> shown in <FIG> is omitted.

For example, there is a case where a currently existing tooth (denoted by the reference numeral <NUM> in the three-dimensional image <NUM>) is extracted and an implant body <NUM> is embedded into the position from which the tooth has been extracted. In this case, the tooth <NUM> to be extracted exists at the treatment objective site of the first three-dimensional image <NUM> in the upper jaw prior to the treatment. Based on the dentist's instruction, the control apparatus <NUM> is configured to three-dimensionally cut the tooth <NUM> to be extracted in the first three-dimensional image <NUM> and the second three-dimensional image <NUM>. Thus, based on the dentist's instruction, the control apparatus <NUM> forms a region <NUM> in the first three-dimensional image <NUM>, and forms a region <NUM> in the second three-dimensional image <NUM>. The shapes of the regions (spaces) <NUM> and <NUM> can be suitably set by the dentist.

The dentist performs the process at step S3 of the flow shown in <FIG>. Thus, the control apparatus <NUM> creates, based on the dentist's instruction, three-dimensional images relating to the not-to-be-reached targets (third three-dimensional images 553a, 553b, and 553c (see <FIG>)). It is to be noted that, in the case of performing the above-described maxillary sinus floor augmentation, the maxillary sinus floor mucosa 730a of the maxillary sinus <NUM>, as well as the posterior superior alveolar bone artery and the greater palatine artery, is the not-to-be-reached target of the drill body <NUM>, which is the hole-forming instrument <NUM>.

Based on the dentist's instruction, the control apparatus <NUM> performs the process at step S4 in the flow shown in <FIG>. The control apparatus <NUM> sets the fourth three-dimensional image <NUM> corresponding to the implant body in such a manner that a distal end of the implant body <NUM> is placed at a position that does not reach a specified target, and sets a fifth three-dimensional image <NUM> corresponding to the hole-forming instrument.

Thereafter, based on the dentist's instruction, the control apparatus <NUM> performs the processing at steps S5-S11 in the flow shown in <FIG>.

It is to be noted that the processing at and after step S5 is performed based on three-dimensional images <NUM> and <NUM> in which the regions <NUM> and <NUM> are formed. Thus, the sixth three-dimensional image <NUM> corresponding to the surgical guide is formed in such a manner that the tooth image <NUM> in <FIG> does not exist, and the drill hole image 556a is formed in a circular shape that conforms to the shape of the hole-forming instrument <NUM>. It is to be noted that, if the tooth image <NUM> exists, a deformed space is formed in which the shape of the tooth image <NUM> is cut out from the drill hole image 556a.

According to the above-described first embodiment and second embodiment including their modifications, the dentist can perform pre-procedure advance verification to verify, prior to performing a treatment of embedding an implant body <NUM> or an autologous tooth, whether or not there is any problem in the treatment plan, including selection of various treatment instruments, using a model <NUM> produced using a system <NUM> for advance verification of a dental treatment, a hole-forming instrument (procedural instrument) <NUM> to be used in an actual dental treatment, and the implant body <NUM> or an autologous tooth <NUM>. This prevents the dentist from suspecting whether or not tools used during the procedures (e.g., the hole-forming instrument <NUM>) are adequate for performing a predetermined treatment of the treatment objective site of the patient in accordance with the treatment plan, thus taking a long time for the treatment and putting a burden on the patient. Thus, by using the system <NUM> and the model <NUM> according to the above-described first embodiment and second embodiment including their modifications and the hole-forming instrument <NUM> set in the treatment plan, it is possible to perform a less-invasive dental treatment on the patient.

Also, by allowing the dentist, not the professional, to perform the operation of creating a treatment plan using the system <NUM> until a three-dimensional image of the model <NUM> is created, while allowing the dentist who actually performs the treatment to perform confirmation, it is possible to perform a treatment of embedding, for example, the implant body <NUM> or an autologous tooth in a safer manner.

Claim 1:
A model (<NUM>) for pre-procedure verification of a dental treatment plan, comprising:
a model main body (<NUM>) formed based on a jaw of a patient in a size and a shape identical to at least a part of a treatment objective site of the jaw of the patient and configured to model the at least a part of the treatment objective site;
an opening defining portion (<NUM>) provided in the model main body (<NUM>) and configured to define an opening corresponding to a recessed opening (<NUM>, <NUM>, <NUM>) for embedding an embedded body in the treatment objective site; and
a target model portion (<NUM>) configured to model a target adjacent to or embedded in an alveolar bone (<NUM>, <NUM>) of the treatment objective site,
the target model portion (<NUM>) allowing a distal end of a procedural instrument used for a treatment to be out of contact with the target model portion (<NUM>) under a condition that the procedural instrument passes through the opening defining portion (<NUM>) in a positional relationship of the target model portion (<NUM>) identical to a positional relationship of the target relative to the treatment objective site, or
the target model portion (<NUM>) allowing the distal end of the procedural instrument to be in contact with the target model portion (<NUM>) under a condition that the procedural instrument passes through the opening defining portion (<NUM>) in a positional relationship of the target model portion (<NUM>) closer than the positional relationship of the target relative to the treatment objective site,
wherein:
a space (<NUM>) is formed between the opening defining portion (<NUM>) and the target model portion (<NUM>) to allow visual recognition of a range present between the opening defining portion (<NUM>) and the target model portion (<NUM>), the range including a reachable range of the distal end of the procedural instrument from the opening defining portion (<NUM>) toward the target model portion (<NUM>) and a reachable range of the distal end of the procedural instrument from the opening defining portion (<NUM>) in a teeth alignment direction and a direction intersecting the teeth alignment direction.