Patent Description:
Dental procedures are often performed to make adjustments to a patient's dentition. Examples of common adjustments that are made include occlusal equilibration, orthodontic alignment of the teeth (such as using braces), installation of dental restorations (including dental implants and crowns) and surgical adjustments (such as implant-supported dentures or orthognathic surgery).

Whenever an adjustment is made to the teeth, it is important for the dentist to avoid making changes that will cause interference with teeth of the opposing dentition. For example, if the adjustment results in a tooth or restoration that is extruded (e.g., too tall and not matching the opposing teeth vertically), an interference will occur between the tooth and the opposing teeth when the patient bites down. As a result, efforts are made to avoid introducing such interference.

However, even with efforts to avoid introducing adjustment-based interference, further changes can occur in the patient's jaw motion as a result of adjustments made in the patient's dentition. Such changes can result in undesirable interference. During the EPO prosecution, the following patent application publications have been identified: <CIT> and <CIT>. In <CIT>, methods and systems are disclosed for diagnosing and generating a treatment plan for temporomandibular joint dysfunction where a polymeric shell appliance is utilized to generate one or more activation forces that facilitate tooth movement. The polymeric shell appliances may comprise one or more tooth receiving cavities, in which each of the plurality of tooth receiving cavities is shaped and arranged to provide a counter moment of each of the plurality of teeth. In <CIT>, a computer-implemented method of using a dynamic virtual articulator for simulating occlusion of teeth is disclosed when performing computer-aided designing of one or more dental restorations for a patient, where the method comprises the steps of: providing the virtual articulator comprising a virtual three-dimensional model of the upper jaw and a virtual three-dimensional model of the lower jaw resembling the upper jaw and lower jaw, respectively, of the patient's mouth; providing movement of the virtual upper jaw and the virtual lower jaw relative to each other for simulating dynamic occlusion, whereby collisions between teeth in the virtual upper and virtual lower jaw occur; wherein the method further comprises: providing that the teeth in the virtual upper jaw and virtual lower jaw are blocked from penetrating each other's virtual surfaces in the collisions.

One aspect is a computer implemented method of analyzing a dental treatment plan, as defined in claim <NUM>.

Another aspect is a system for analyzing a dental treatment plan, according to any of claims <NUM>-<NUM>, as defined in claim <NUM>.

These and other aspects and embodiments are described in greater detail below, in reference to the attached drawing figures.

A patient's dentition consists of teeth of both upper and lower dental arches on the upper and lower jaw, respectively. Certain dental procedures performed by a dentist on the patient involve adjusting a tooth or teeth of one or both dental arches. In some examples, the dental procedure can involve occlusal equilibration. In other examples, the dental procedure can involve dental restorations, including dental implants, bridges, and/or crowns. In further examples, the dental procedure can involve orthodontic alignment of the teeth, including use of braces. In yet further examples, the dental procedure can involve surgical adjustments, including implant-supported denture surgeries and orthognathic surgeries. Moreover, the dental procedure can involve a combination of occlusal equilibration, dental restorations, orthodontic alignment of teeth, and surgeries.

Whenever an adjustment is made to a tooth, there is a potential that the adjustment will cause interference with teeth of the opposing dental arch. For example, if the adjustment results in the tooth being extruded (e.g., too tall and not matching the opposing teeth vertically), an interference will occur between the tooth and the opposing teeth when the patient bites down. Additionally, changes can occur in the patient's jaw motion as a result of the adjustment made to the tooth. For example, prior to the dental procedure, the patient's dentition may already have some interference that has caused the patient's jaw motion to be restricted, such as a shape of the tooth or the way in which the tooth fits together with an opposing tooth that restricts the jaw to only move so far vertically, anteroposteriorly, and transversely (e.g., up and down, front and back, and side to side). In some situations, the interference is removed as a result of the adjustment to the tooth, causing the jaw motion to adjust and have a less restricted, more extensible movement in one or more directions, which in turn causes the teeth to move relative to one another in different ways. For example, a particular tooth can now move further vertically, anteroposteriorly, or transversely (e.g., further up or down, front or back, or side to side), which changes the way the tooth fits or interacts with teeth of the opposing dental arch, and can cause an interference that affects the patient's bite or chewing.

Often times, when generating and performing a dental treatment plan that involves a dentition adjustment, a dentist only takes into account and proactively avoids interferences with opposing teeth directly created by the dentition adjustment, and does not consider subsequent jaw motion changes and corresponding effects. As a result, when the dentition is adjusted, a corresponding jaw motion adjustment can occur that was not accounted for in the dental treatment plan. Even if the dentist performs a scan post-procedure, this scan is static (e.g., comprised of multiple static bites) and may not capture interferences created from the jaw motion adjustment. Accordingly, the patient may leave the dentist office unaware, but as the patient more dynamically moves their jaw (e.g., when chewing food), the patient may then notice and experience discomfort or pain due to the interference requiring the patient to return to the dentist for a correction. Once the interference is identified, the patient will need to spend additional time at the dentist office for the dentist to modify the preparation and/or materials used for the dental procedure, and may still need to come back for a later visit if the dentist needs to order new materials (e.g., a new crown) based on the changes caused by the interference. In other scenarios, the motion of the jaw may change slowly over time as a result of the dentition adjustment causing a new interference. Similarly, additional visits to the dentist office will be required once effects of the new interference are noticed by the patient in order to identify and correct the new interference.

To proactively avoid interferences caused by both dentition adjustment and jaw motion adjustment and prevent a patient from enduring multiple unnecessary office visits, embodiments described herein can be implemented to predict a motion adjustment responsive to a dental treatment plan including a dentition adjustment. The dental treatment plan can then be modified to accommodate the predicted motion adjustment prior to performance of the dentition adjustment. Additionally, data collected to predict the motion adjustment, such as scans of the patient's dentition, motion data from dentition motion assessments, and various digital models generated therefrom, and data associated with the predicted motion adjustment, such as interference boundaries, can be stored for use and/or reference in future dental procedures.

<FIG> is a flow chart illustrating an example method <NUM> of analyzing a dental treatment plan. The method <NUM> can be implemented, for example, by the example patient evaluation system <NUM> described herein with reference to <FIG> below. In this example, the method <NUM> includes operations <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>.

Prior to performing a dental procedure, a scan of a patient's dentition is performed at operation <NUM>. The scan identifies a position and an orientation of each tooth in the upper and lower dental arches of the patient's dentition with respect to each other tooth.

At operation <NUM>, a dentition motion assessment is performed. The dentition motion assessment captures motion data representing the movement of the patient's dental arches relative to each other. For example, the dentition motion assessment captures how each tooth in the upper and lower dental arches move with respect to one another.

In some embodiments, a pre-treatment interference boundary can be determined utilizing the position and orientation of each tooth in the dental arches provided by the scan and the movement of each tooth in the dental arches provided by the motion data. The pre-treatment interference boundary is a boundary of function between teeth of opposing dental arches before a treatment plan has been implemented. The pre-treatment interference boundary is defined by the interface or interaction between the teeth on the opposing dental arches. For example, the pre-treatment interference boundary indicates how far any of the teeth can move vertically, anteroposteriorly, and transversely. If a tooth extends or crosses over the pre-treatment interference boundary in one or more planes, an interference with teeth of the opposing dental arch of the dentition is created.

To provide additional context, the pre-treatment interference boundary may be analogous to a functionally generated pathway (FGP) of occlusion. An FGP is generated based on registered paths of movement of occlusal surfaces of the teeth of one dental arch, to the teeth or occlusion rims of the opposing dental arch that are recorded using a medium. An example technique for generating an FGP includes adapting a material over the occlusal surface of a tooth or teeth and having the patient occlude the teeth in the intercuspal position and move the lower jaw throughout all excursions. This allows the opposing teeth to three-dimensionally record border movements in each jaw position in the material to define a boundary of function between teeth of opposing dental arches. However, the pre-treatment interference boundary may be determined more quickly and accurately (and with less inconvenience to the patient) based on the position and orientation of each tooth in the dental arches provided by the scan and the movement of each tooth in the dental arches provided by the motion data.

An interference boundary can be thought of as a surface that would be generated if a tray, containing a pliable material such as paste or gel, was mounted to one of the dental arches, and then the patient were to bite down into the material and move the opposing dentition around in all directions. The result would be a surface that records the furthest extent that the teeth can reach. For example, a surface that records perimeters of a boundary defining a vertical, anteroposterior, and traversal reach of the teeth. This same or similar type of an interference boundary can be generated and stored digitally.

At operation <NUM>, a dental treatment plan with a dentition adjustment is determined based on the scan and the dentition motion assessment. The dentition adjustment can involve any kind of change in the structure or positions of the teeth. To provide some examples, the dentition adjustment can include a removal, re-shaping, and/or re-alignment of a portion or entirety of a tooth or teeth on one or both dental arches of the patient's dentition. When determining the dental treatment plan, the adjustment to a tooth or teeth of one dental arch of the dentition is defined to avoid an interference with teeth of the opposing dental arch of the dentition. For example, the scan performed at operation <NUM> and the motion data obtained from the dentition motion assessment performed at operation <NUM> are utilized to visualize a position and orientation of a tooth associated with the dentition adjustment and how the tooth can move vertically, anteroposteriorly, and transversely to ensure that the dentition adjustment does not move or adjust the tooth beyond the confines of the pre-treatment interference boundary (e.g., does not violate the pre-treatment interference boundary to avoid creating an interference).

However, even with efforts to avoid introducing interference by accounting for the dentition adjustment, changes can occur in the patient's jaw motion as a result of adjustments made to the patient's dentition. Additionally or alternatively, changes in the patient's jaw motion can be caused by changes to joints of the jaw (e.g., as a result of surgery). Such changes in jaw motion can also result in undesirable interference. Therefore, to further bolster efforts to avoid introducing interference, the changes occurring to the patient's jaw motion as a result of the dentition adjustment can also be accounted for by predicting a motion adjustment based on the dentition adjustment at operation <NUM>. For example, a determination is made as to whether an interference will be removed after the dentition adjustment (e.g., whether an already existing interference within patient's dentition due to a shape of a tooth or current interactions between teeth will be removed) and, if so, a determination of associated effects of the interference removal (e.g., a determination of changes to the jaw motion) is made to predict the motion adjustment. In some examples, because the jaw's range of motion influences how far a tooth or teeth may be able to move in direction and magnitude, the associated effects of the removal can cause a change to the pre-treatment interference boundary. Thus, a post-dentition adjustment interference boundary is predicted to represent the interference boundary following the dentition adjustment and removal of the interference.

At operation <NUM>, the dental treatment plan is modified based on the predicted motion adjustment. For example, if it is determined that the dentition adjustment proposed by the dental treatment plan will cause changes to the jaw motion, the dental treatment plan is modified to accommodate the predicted motion adjustment so that the dental treatment plan continues to avoid introducing any interference. As one example, a jaw motion change may result in a change to the pre-treatment interference boundary. For example, the jaw may now be more or less extensible, and the boundary may change accordingly. Therefore, the dental treatment plan is modified to ensure that the dentition adjustment made does not go beyond the confines of or violate the predicted post-dentition adjustment interference boundary. Accordingly, the modified dental treatment plan proactively accounts for (e.g., in order to avoid) interferences caused by both the dentition adjustment and subsequent motion adjustment of the jaw.

In some embodiments the operations <NUM> and <NUM> can be repeated one or more times until interference is eliminated, or until the interference is less than a predetermined amount. For example, the predetermined amount is less than a predetermined overlap distance. Once the interference is eliminated, or the interference is less than the predetermined amount, the modified dental treatment plan can be performed at operation <NUM>.

<FIG> is a schematic block diagram illustrating an example patient evaluation system <NUM> for implementing the method <NUM> of analyzing a dental treatment plan described in <FIG>. The patient evaluation system <NUM> includes a scanner <NUM>, a motion capture station <NUM>, and a treatment plan generation system <NUM>.

Prior to a dentist D performing a dental procedure on a patient P, a scan <NUM> of dentition of the patient P is captured by the scanner <NUM> to perform operation <NUM> and a dentition motion assessment <NUM> is performed on patient P by the motion capture station <NUM> to perform operation <NUM>. The scan <NUM> and dentition motion assessment <NUM> are provided as input to the treatment plan generation system <NUM>.

The scan <NUM> provides a position and an orientation of each tooth in the upper and lower dental arches of the dentition with respect to each other tooth. The dentition motion assessment <NUM> comprises motion data providing the movement of the dental arches relative to each other, including how each tooth in the upper and lower dental arches move with respect to one another. In some examples, the dentition motion assessment <NUM> also provides a pre-treatment interference boundary. In other examples, the treatment plan generation system <NUM> determines the pre-treatment interference boundary from data associated with the scan <NUM> and the dentition motion assessment <NUM>. The pre-treatment interference boundary is a boundary of function between teeth of opposing dental arches before a treatment plan has been implemented, and is defined by the interface or interaction between the teeth on the opposing dental arches. For example, the pre-treatment interference boundary indicates how far each particular tooth can move vertically, anteroposteriorly, and transversely. If a tooth extends or crosses over the pre-treatment interference boundary in one or more planes, an interference with teeth of the opposing dental arch of the dentition is created.

Based on the data associated with the scan <NUM> and dentition motion assessment <NUM>, the treatment plan generation system <NUM> determines a dental treatment plan <NUM> that includes a dentition adjustment <NUM> to perform operation <NUM>. The dentition adjustment <NUM> can involve any kind of change in the structure or positions of the teeth, such as a removal, re-shaping, and/or re-alignment of a portion or entirety of a tooth or teeth on one or both dental arches of the patient P's dentition, among other examples. When determining the dental treatment plan <NUM>, the dentition adjustment <NUM> is defined to avoid an interference between a tooth or teeth associated with the dentition adjustment <NUM> and teeth of the opposing dental arch of the dentition. For example, data from the scan <NUM> and the dentition motion assessment <NUM> are utilized to visualize a position and orientation of a tooth or teeth associated with the dentition adjustment <NUM> and how the tooth or teeth can move vertically, anteroposteriorly, and transversely to ensure that the dentition adjustment does not move or adjust the tooth or teeth beyond the confines of the pre-treatment interference boundary (e.g., does not violate the pre-treatment interference boundary to avoid introducing an interference).

However, because the dental treatment plan <NUM> includes the dentition adjustment <NUM> and changes can occur in the patient's jaw motion as a result of the dentition adjustment <NUM>, the treatment plan generation system <NUM> further determines a predicted motion adjustment <NUM> based the dentition adjustment <NUM> to perform operation <NUM>. For example, a determination is made as to whether an interference will be removed after the dentition adjustment <NUM> and if so, a determination of associated effects of the removal of the interference (e.g., a determination of changes to the jaw motion) is made to determine the predicted motion adjustment <NUM>. In some examples, because the jaw's range of motion influences how far a tooth or teeth may be able to move in direction and magnitude, the associated effects of the removal of the interference can cause a change to the pre-treatment interference boundary. Thus, a post-dentition adjustment interference boundary is predicted to represent the interference boundary following the changes resulting from the removal of the interference.

The treatment plan generation system <NUM> then uses the predicted motion adjustment <NUM> to modify the dental treatment plan <NUM> to create a modified dental treatment plan <NUM> to perform operation <NUM>. For example, if it is determined that the dentition adjustment <NUM> of the dental treatment plan <NUM> will cause changes to the jaw motion, the dental treatment plan <NUM> is modified to accommodate the predicted motion adjustment so that the dental treatment plan <NUM> continues to avoid introducing any interference. As one example, a jaw motion change may result in a change to the pre-treatment interference boundary. For example, the jaw may now be more or less extensible, and the boundary may change accordingly. Therefore, the dental treatment plan <NUM> is modified to the modified dental treatment plan <NUM> to accommodate the predicted motion adjustment <NUM>. For example, the modified dental treatment plan <NUM> ensures that the dentition adjustment <NUM> made does not go beyond the confines of or violate the predicted post-dentition adjustment interference boundary.

To perform operation <NUM>, the treatment plan generation system <NUM> provides the modified dental treatment plan <NUM> as output to the dentist D such that the dentist D performs <NUM> the modified dental treatment plan <NUM> that proactively avoids introducing interferences potentially caused by both the dentition adjustment <NUM> and the predicted motion adjustment <NUM>.

<FIG> is another schematic block diagram illustrating another example of the patient evaluation system <NUM>, shown in <FIG>, for implementing the method <NUM> of analyzing a dental treatment plan described in <FIG>. The example patient evaluation system <NUM> includes the scanner <NUM>, the motion capture station <NUM>, and the treatment plan generation system <NUM> as described in <FIG>. The treatment plan generation system <NUM> includes an interference boundary generator <NUM>, a treatment plan generator <NUM>, and a motion analyzer <NUM>. In optional embodiments, the patient evaluation system <NUM> further comprises a rapid fabrication machine <NUM> and/or restoration fabrication station <NUM>, and a restoration installation station <NUM>.

In some embodiments, various components of the patient evaluation system <NUM> may be at least partially located within a physical dental office and/or a dental lab. Additionally, any of the computerized functions could be performed in the dental office, dental lab, or remotely by, or in cooperation with, one or more other computing devices (including client, server, or cloud computing devices), and any number of computing devices can be used to perform all or any part of the system. For example, in some embodiments, the patient evaluation system <NUM> may comprise a web-based service performing various functions of the system.

The system and methods begin by scanning the dentition of the patient P to perform operation <NUM>. For example, scanner <NUM> performs the scan <NUM>, from which a position and an orientation of each tooth in the upper and lower dental arches of the dentition is determined with respect to each other tooth. The scanner <NUM> can be an intraoral scanner, where example intraoral scanners include the Medit Intraoral Scanner, TRIOS Intra Oral Digital Scanner, the Lava Chairside Oral Scanner C. , the Cadent iTero, the Cerec AC, the Cyrtina IntraOral Scanner, and the Lythos Digital Impression System from Ormco. In other embodiments, the dentition of the patient P is captured using other imaging technologies, such as computed tomography (CT) or magnetic resonance imaging (MRI). In some examples, the type of CT used is Dental Cone Beam CT (Dental CBCT).

In some examples, the scanner <NUM> is capable of creating a digital dental model <NUM>, which is a three-dimensional digital representation of the dentition of the patient P from the scan <NUM>. For example, the scanner <NUM> comprises a laser scanner, a touch probe, or an industrial CT scanner, among other types of scanners capable of creating three-dimensional digital representations. In some embodiments, the scanner <NUM> generates a point cloud, a polygonal mesh, a parametric model, or voxel data representing the dentition of the patient P.

Some embodiments further include a segmentation tool that analyzes the digital dental model <NUM> generated from the scanner <NUM> and segments the model to separate each tooth from adjacent teeth, which is then saved into the digital dental model <NUM>. The segmentation tool can be a part of the scanner <NUM>, or can be a separate component. In some embodiments, the segmentation tool can be one of a variety of tools provided by the treatment plan generator <NUM> described in detail in <FIG>. An example of the segmentation tool is an auto-segmentation software application. Auto-segmentation software and related techniques are described in <NPL>. Segmentation is useful, for example, to allow individual teeth (or groups of teeth) within the digital dental model <NUM> to be moved relative to the other teeth when generating the treatment plan using the treatment plan generator <NUM>, discussed in further detail herein.

To perform operation <NUM>, the dentition motion assessment <NUM> is performed on patient P using the motion capture station <NUM> to generate motion data <NUM> representing the movement of the dental arches relative to one another. In some embodiments, the motion capture station <NUM> generates the motion data <NUM> from optical measurements of the dental arches that are captured while the dentition of the patient P is moved. In some embodiments, the optical measurements are extracted from image or video data recorded while the dentition of the patient P is moved. Additionally, in some embodiments, the optical measurements are captured indirectly. For example, the optical measurements are extracted from images or video data of one or more devices that are secured to a portion of the dentition of the patient.

In other embodiments, still images are captured of the patient's dentition while the dentition of the patient is positioned in a plurality of bite locations. In some embodiments, image processing techniques are used to determine the positions of the patient's upper and lower arches relative to each other (either directly or based on the positions of attached devices). In some embodiments, the motion data <NUM> is generated by interpolating between the positions of the upper and lower arches determined from at least some of the captured images.

Examples of the motion capture station <NUM> are described in <CIT>, and titled DETERMINING JAW MOVEMENT. For example, the motion capture station <NUM> may comprise a patient assembly that includes a clutch to be worn by the patient P on a dentition of the patient P. The clutch includes a dentition coupling device to couple to the dentition of the patient P and a position indicating system rigidly connected to the dentition coupling device, where the position indicating system emits a plurality of light beams. The motion capture station <NUM> can also include an imaging system and a motion determining device, where the imaging system captures a plurality of image sets that each include at least one of a plurality of screens upon which the light beams project, and the motion determining device processes the captured image sets to determine the motion of the patient's dentition.

In other embodiments, the motion data <NUM> is generated using other processes. Further, in some embodiments, the motion data <NUM> includes transformation matrices that represent the position and orientation of the dental arches. Other embodiments of the motion data <NUM> are possible as well.

The treatment plan generation system <NUM> receives the digital dental model <NUM> and the motion data <NUM> as input. The treatment plan generation system <NUM> includes one or more components and/or sub-systems including at least the interference boundary generator <NUM>, the treatment plan generator <NUM>, and the motion analyzer <NUM>.

The interference boundary generator <NUM> of the treatment plan generation system <NUM> determines a pre-treatment interference boundary <NUM> based on the position and orientation of each tooth provided by the digital dental model <NUM> and the movement of each tooth relative to one another provided by the motion data <NUM>. The pre-treatment interference boundary <NUM> is a boundary of function between teeth of the dental arch on the upper jaw and teeth of the opposing dental arch on the lower jaw, and is defined by the interface or interaction between the teeth on the opposing dental arches before a treatment plan is implemented. For example, the pre-treatment interference boundary <NUM> identifies for all possible positions of the dental arches, the boundary at which no teeth from the opposing arch will cross. If any teeth do cross over the pre-treatment interference boundary in one or more planes, an interference with teeth of the opposing dental arch of the dentition is created.

The treatment plan generator <NUM> of the treatment plan generation system <NUM> determines the dental treatment plan <NUM>. The dental treatment plan <NUM> includes at least one dentition adjustment <NUM> for the patient P. The dentition adjustment <NUM> involves any kind of change in the structure or positions of the teeth. In one example, the dentition adjustment <NUM> can be an occlusal equilibration, whereby a surface of a tooth on one or both dental arches is altered (e.g., by raising a surface of the tooth or grinding down the surface of the tooth) to allow the jaw joints to be in the proper anatomical location when the teeth on opposing arches come into contact. In another example, the dentition adjustment <NUM> can be a restoration preparation or a corresponding temporary or provisional restoration, such as the preparation for a crown or a bridge that involves cutting down and/or re-shaping a portion or entirety of a tooth or teeth, as described in further detail in <FIG>. In a further example, the dentition adjustment <NUM> can be a dental alignment, such as an orthodontic alignment, as described in further detail in <FIG>. In yet further examples, the dentition adjustment <NUM> involve a dental surgery that reshapes the jaw causing the change in the structure or positions of the teeth.

Typically, the treatment plan generator <NUM> operates in cooperation with an operator user, such as the dentist D, to receive inputs to generate the dental treatment plan <NUM>. For example, in some embodiments, the treatment plan generator <NUM> comprises at least one computing device including one or more user input devices through which input from the operator user is received. Using the digital dental model <NUM>, the motion data <NUM>, and the pre-treatment interference boundary <NUM> determined by the interference boundary generator <NUM>, the treatment plan generator <NUM>, in conjunction with the operator user, can define at least one dentition adjustment <NUM> of the dental treatment plan <NUM>. Particularly, the dentition adjustment <NUM> is defined to avoid an adjustment that will cause interference with teeth of the opposing dentition. For example, a tooth or restoration that is recessed from the pre-treatment interference boundary <NUM> cannot interfere with the opposing dentition, whereas a tooth that projects past the pre-treatment interference boundary <NUM> will interfere with the movement of the opposing dentition. Therefore, the digital dental model <NUM>, the motion data <NUM>, and the pre-treatment interference boundary <NUM> are utilized to visualize a position and orientation of a tooth associated with the dentition adjustment <NUM> and how the tooth can move vertically, anteroposteriorly, and transversely to ensure that the dentition adjustment <NUM> does not move or adjust the tooth beyond the confines of the pre-treatment interference boundary <NUM> (e.g., does not violate the pre-treatment interference boundary <NUM> to avoid introducing an interference).

In some embodiments, the dental treatment plan <NUM> is generated as three-dimensional digital data that represents a dental treatment plan (DTP) model <NUM>. For example, the DTP model <NUM> comprises a three-dimensional representation of the dentition of the patient with the dentition adjustment <NUM>.

In some embodiments, the treatment plan generator <NUM> includes computer-aided-design (CAD) software that generates a graphical display of the digital dental model <NUM> and, either automatically or in cooperation with the operator user generates the DTP model <NUM> that identifies the at least one dentition adjustment <NUM> from the original digital dental model <NUM>. In some embodiments the operator user interacts with and manipulates the DTP model <NUM> to define the adjustments to be made, as discussed above. In some embodiments, the treatment plan generator <NUM> comprises digital tools that mimic the tools used by laboratory technicians, as described in greater detail in <FIG> below. Additionally, in some embodiments, the treatment plan generator <NUM> comprises a computing device that partially or fully automates the generation of the DTP model <NUM>.

As described in the example embodiments above, the DTP model <NUM> is generated to include the dentition adjustment <NUM> as a simulation of the dentition adjustment (e.g., without the dentition adjustment actually being performed). In other example embodiments, the dentition adjustment <NUM> can be performed according to the dental treatment plan <NUM>, another scan of the dentition post-dentition adjustment is captured by the scanner <NUM>, and the DTP model <NUM> is generated based on the post-dentition adjustment scan (e.g., the DTP model <NUM> is a three-dimensional representation of the patient's dentition after the dentition adjustment has been performed).

The motion analyzer <NUM> of treatment plan generation system <NUM> predicts a motion adjustment based on the dentition adjustment <NUM>. For example, the motion analyzer <NUM> analyzes the DTP model <NUM>, along with the motion data <NUM>, to predict what changes will occur in the patient's jaw motion as a result of the dentition adjustment <NUM>, and then analyzes the DTP model <NUM> based on the predicted changes in the patient's jaw motion (e.g., to collect analysis data <NUM>).

Various embodiments can be implemented by the motion analyzer <NUM> to predict the motion adjustment. In one or more of the embodiments, a location of a screw axis of the patient's jaw is determined. The screw axis corresponds to the condyloid process of the temporomandibular joint of the patient P, and is an axis about which the lower jaw rotates and translates along an eminence of a condyle of the condyloid process when in function. Accordingly, the location of the screw axis imposes limitations on a range of motion of the jaw. Mathematical coordinates of the range of motion relative to the patient's dentition can be determined and used as parameters for simulating the motion of the jaw. Other j aw-related characteristics or parameters, such as a flexibility or "sponginess" of the temporomandibular joint, can be determined and used as data input for simulating the motion of the jaw. For example, the DTP model <NUM> that includes the dentition adjustment <NUM> can be used in conjunction with the screw axis location and other jaw-related parameters to simulate the motion of the jaw after the dentition adjustment <NUM>, as described in greater detail in <FIG>, to predict the motion adjustment.

In some embodiments, a post-dentition adjustment interference boundary <NUM> is predicted based on the analysis data <NUM> to determine a change from the location of the pre-treatment interference boundary <NUM>. For example, the motion analyzer <NUM> can provide the analysis data <NUM> to the interference boundary generator <NUM>, the analysis data <NUM> including the predicted motion adjustment <NUM> resulting from the dentition adjustment <NUM>. The interference boundary generator <NUM> can generate a post-dentition adjustment interference boundary <NUM> based on the analysis data <NUM> and the DTP model <NUM>, and provide the post-dentition adjustment interference boundary <NUM> to the treatment plan generator <NUM>.

The treatment plan generator <NUM> can then modify the dental treatment plan <NUM> as needed to create a modified dental treatment plan <NUM>. For example, if it is determined that the dentition adjustment <NUM> of the dental treatment plan <NUM> will cause changes to the jaw motion, the dental treatment plan <NUM> is modified to accommodate the predicted motion adjustment so that the dental treatment plan <NUM> continues to avoid introducing any interference. As one example, if based on the change between the pre-treatment interference boundary <NUM> and the post-dentition adjustment interference boundary <NUM>, it is determined that the dentition adjustment <NUM> proposed by the dental treatment plan <NUM> will cause an interference to be removed that subsequently will adjust a motion of the jaw, the treatment plan generator <NUM> modifies the dental treatment plan <NUM> to accommodate the predicted motion change in the modified dental treatment plan <NUM>. For example, the dentition adjustment <NUM> can be modified to ensure that a tooth associated with the dentition adjustment <NUM> does not go beyond the confines of or violate the predicted post-dentition adjustment interference boundary <NUM>. The treatment plan generator <NUM> can then correspondingly adjust the DTP model <NUM> to generate a modified DTP model <NUM> based on the modified dental treatment plan <NUM>.

The treatment plan generation system <NUM> may store the patient's data including one or more of the scan <NUM>, the digital dental model <NUM>, the dentition motion assessment <NUM>, the motion data <NUM>, the pre-treatment interference boundary <NUM>, the dental treatment plan <NUM> with dentition adjustment <NUM>, the DTP model <NUM>, the analysis data <NUM>, the post-dentition adjustment interference boundary <NUM>, the modified dental treatment plan <NUM>, and the modified DTP model <NUM>, among other patient data. The patient's data can be used to facilitate and inform future dental procedures. The patient's data may be stored in a database <NUM> associated with the treatment plan generation system <NUM> and/or patient evaluation system <NUM>.

In some embodiments, the modified DTP model <NUM> includes a digital model of a restoration associated with the modified dental treatment plan <NUM> that can be optionally provided to a rapid fabrication machine <NUM>. In some embodiments, the rapid fabrication machine <NUM> comprises one or more three-dimensional printers, such as the ProJet line of printers from 3D Systems, Inc. of Rock Hill, South Carolina. Another example of the rapid fabrication machine <NUM> is stereolithography equipment. Yet another example of the rapid fabrication machine <NUM> is a milling device, such as a computer numerically controlled (CNC) milling device. In some embodiments, the rapid fabrication machine <NUM> is configured to receive files in the STL format. Other embodiments of the rapid fabrication machine <NUM> are possible as well.

In some embodiments, the rapid fabrication machine <NUM> is configured to use the modified DTP model <NUM> to fabricate the dental restoration component <NUM>. In some embodiments, the dental restoration component <NUM> is a physical component that is configured to be used as part or all of the dental restoration <NUM>. For example, in some embodiments, the dental restoration component <NUM> is milled from zirconium or another material that is used directly as a dental restoration <NUM>. In other embodiments, the dental restoration component <NUM> is a mold formed from wax or another material and is configured to be used indirectly (e.g., through a lost wax casting or ceramic pressing process) to fabricate the dental restoration <NUM>. For example, in some embodiments, the dental restoration <NUM> is formed using traditional techniques (e.g., stacked porcelain or wax-up). In additional examples, when the rapid fabrication machine <NUM> is a three-dimensional printer, underlayments and/or frameworks for the dental restoration component <NUM> can be printed. For example, metal or ceramic underlayments and/or frameworks are printed.

In some embodiments, the restoration fabrication station <NUM> operates to fabricate the dental restoration <NUM> for the patient P. In some embodiments, the restoration fabrication station <NUM> uses the modified DTP model <NUM> or the dental restoration component <NUM> produced by the rapid fabrication machine <NUM>. In some embodiments, the dental restoration <NUM> is a filling, partial crown, full crown, veneer, bridge, complete denture, partial denture, or implant framework. Other embodiments of the dental restoration <NUM> are possible as well. In some embodiments, the dental restoration <NUM> is formed from an acrylic, ceramic, or metallic material. In some embodiments, a model of the dentition of the patient P is generated by the rapid fabrication machine <NUM> using the scan <NUM> (and/or the digital dental model <NUM>) captured by the scanner <NUM>. In some embodiments, the restoration fabrication station <NUM> comprises equipment and process to perform some or all of the techniques used in traditional dental laboratories to generate dental restorations. Other embodiments of the restoration fabrication station <NUM> are possible as well.

In some embodiments, when the dental restoration <NUM> is a crown, for example, the crown is automatically fabricated based on the modified DTP model <NUM> to account for both dentition adjustment and jaw motion adjustment. For example, an occlusal surface of the crown is fabricated to correspond with the predicted post-dentition adjustment interference boundary <NUM>. In some embodiments, a default crown structure is used as a starting template that is then adjusted and contoured based on the predicted post-dentition adjustment interference boundary <NUM>. Specifically, the predicted post-dentition adjustment interference boundary <NUM> is used to define contoured portions of the crown surface that interface with opposing and adjacent teeth to prevent post-dentition adjustment interference. For example, based on the predicted post-dentition adjustment interference boundary <NUM>, one or more rules or parameters are generated to ensure that the post-dentition adjustment interference boundary <NUM> is not violated in any plane by the crown. In some examples, the rules or parameters are associated with a slope of the sidewalls of the crown, in addition to a height and occlusal surface shape of the crown.

In some embodiments, to perform <NUM> the modified dental treatment plan <NUM>, the dentist D may seat the dental restoration <NUM> in the mouth of the patient P or perform another associated dental procedure in accordance with the modified dental treatment plan <NUM> at the restoration installation station <NUM>. In some embodiments, the dentist D confirms that the dental restoration <NUM> properly corresponds to the dental preparation (e.g., the dentition adjustment <NUM>) and the dental restoration <NUM> or other associated dental procedure accounts for any motion changes to the jaw caused by the dental preparation.

Additionally, in some embodiments, various systems, sub-systems, and/or components are connected by network <NUM>. The network <NUM> is an electronic communication network that facilitates communication between the various systems and components of the patient evaluation system <NUM> spread across a dental office, a dental lab, and/or web-based platforms. An electronic communication network is a set of computing devices and links between the computing devices. The computing devices in the network <NUM> use the links to enable communication among the computing devices in the network <NUM>. The network <NUM> can include routers, switches, mobile access points, bridges, hubs, intrusion detection devices, storage devices, standalone server devices, blade server devices, sensors, desktop computers, firewall devices, laptop computers, handheld computers, mobile telephones, and other types of computing devices.

In various embodiments, the network <NUM> includes various types of links. For example, the network <NUM> can include one or both of wired and wireless links, including Bluetooth, ultra-wideband (UWB), <NUM>, ZigBee, and other types of wireless links. Furthermore, in various embodiments, the network <NUM> is implemented at various scales. For example, the network <NUM> can be implemented as one or more local area networks (LANs), metropolitan area networks, subnets, wide area networks (such as the Internet), or can be implemented at another scale.

<FIG> is a block diagram illustrating an example of the treatment plan generator <NUM> of the treatment plan generation system <NUM> described in <FIG>. The treatment plan generator <NUM> includes one or more components, including at least a three-dimensional (3D) modeling system <NUM> and an interference checker <NUM>. In some embodiments, treatment plan generator <NUM> may also include the interference boundary generator <NUM> and the motion analyzer <NUM>. In other embodiments, the interference boundary generator <NUM> and the motion analyzer <NUM> are separate components or sub-systems of the treatment plan generation system <NUM>.

The treatment plan generator <NUM> determines the dental treatment plan <NUM>. The dental treatment plan <NUM> includes at least one dentition adjustment <NUM> for the patient P. Typically, the treatment plan generator <NUM> operates in cooperation with an operator user, such as the dentist D, to generate the dental treatment plan <NUM>. In some examples, the dental treatment plan <NUM> is three-dimensional digital data that represents a dental treatment plan (DTP) model <NUM>.

In some embodiments, the 3D modeling system <NUM> of the treatment plan generator <NUM> includes computer-aided-design (CAD) software that generates a graphical display of a digital dental model <NUM> representing dentition of the patient P before the treatment and, either automatically or in cooperation with an operator user, such as the dentist D, generates the DTP model <NUM> that identifies at least one dentition adjustment <NUM> to be made from the original digital dental model <NUM>. Example software that can be implemented by the 3D modeling system <NUM> include <NUM> Shape CAD/CAM software, Align technology iTero software, Orchestrate Orthodontic Technologies Orchestrate 3D Treatment Planning software, Forestadent Onyx software, and D4D Technologies E4D Dental System, uLab Systems dental aligner planning software, among other similar software. In some embodiments the operator interacts with and manipulates the DTP model <NUM> to define the dentition adjustment <NUM> to be made. Additionally, in other embodiments, the 3D modeling system <NUM> partially or fully automates the generation of the DTP model <NUM>.

In further embodiments, the 3D modeling system <NUM> can include surgical software that is able to determine a new interference boundary (e.g., the post dentition adjustment interference boundary <NUM>) based on changes to a horizontal and/or vertical position of one or both jaws (e.g., a realignment of the jaws) as a result of various types of surgeries. As one example, when performing a surgery for implant-supported dentures, a portion of the bone is removed from each jaw (e.g., about <NUM> from each jaw), which could change the vertical dimension of the jaw. Therefore, a new interference boundary based on the change in vertical dimension can be determined by the software and used to create provisional and/or permanent restorations to be attached to the surgical implant. As another example, when an orthognathic surgery (e.g., corrective jaw surgery) is performed in conjunction with preceding and subsequent dental alignments (e.g., braces), the interference boundary can change as the dimensions of the jaw change. Therefore, multiple new interferences boundaries based on the various stages of change in dimension can be determined by the software (e.g., a boundary post-dental alignment and pre-surgery, a boundary post-surgery, and a boundary post-dental alignment).

In further embodiments, the 3D modeling system <NUM> comprises digital tools that mimic the tools used by laboratory technicians. Example tools include definition tools, movement tools, alignment tools, segmentation tools, measurement tools, and preparation tools, among other similar tools. In some embodiments, these tools enable a user, such as the dentist D, to interact with and manipulate the digital dental model <NUM> in accordance with the motion data <NUM> to develop the dental treatment plan <NUM> and define the dentition adjustment <NUM> within the DTP model <NUM>. In other embodiments, the tools may be automated (e.g., do not require user interaction/manipulation).

Definition tools can define the dentition adjustment <NUM> associated with the dental treatment plan <NUM>. Movement tools can move the patient's dentition according to the motion data <NUM> (which may be similar to a physical articulator, for example). Alignment tools can be used to simulate an alignment of a tooth or teeth with adjacent and/or opposing teeth based on digital dental model <NUM>. Segmentation tools segment the digital dental model <NUM> to separate each tooth from adjacent teeth, which is useful, for example, to allow individual teeth (or groups of teeth) within the digital dental model <NUM> to be moved relative to the other teeth. Measurement tools allow a user, such as dentist D, to perform measurements that may be needed to determine a shape, size, or type of materials that will be needed for a restoration and/or for determining the parameters for the restoration preparation (e.g., how much of and which portion of a tooth to grind, as well as how to shape). Preparation tools enable simulation of at least part of the dental procedure (e.g., a preparation for a restoration) on a tooth or teeth. For example, if the dental procedure is a crown restoration, a tooth may be cut down and shaped within the digital dental model <NUM> to simulate the crown preparation to be performed.

The interference checker <NUM> is used by the 3D modeling system <NUM> to aid in the definition of the dentition adjustment <NUM> within the DTP model <NUM> to avoid an adjustment that will cause interference with teeth of the opposing dentition due to a tooth that projects past a pre-treatment interference boundary <NUM>, for example. The pre-treatment interference boundary <NUM> is a boundary of function between teeth of the dental arch on the upper jaw and teeth of the opposing dental arch on the lower jaw, and is defined by the interface or interaction between the teeth on the opposing dental arches before a treatment plan is implemented. In some embodiments, the interference boundary generator <NUM> uses the digital dental model <NUM> and the motion data <NUM> to determine and provide the pre-treatment interference boundary <NUM> to the interference checker <NUM>. The interference checker <NUM> is then used in conjunction with the 3D modeling system <NUM> to ensure that the dentition adjustment <NUM> does not move or adjust the tooth or teeth beyond the confines of the pre-treatment interference boundary <NUM> (e.g., does not violate the pre-treatment interference boundary <NUM>).

If the interference checker <NUM> identifies a violation of the pre-treatment interference boundary <NUM> as the 3D modeling system <NUM> and/or operator user are defining or manipulating the dentition adjustment <NUM> to generate the DTP model <NUM> from the original digital dental model <NUM>, an alert may be provided within the graphical display of the digital dental model <NUM>. In some embodiments, the interference checker <NUM> is also configured to provide color coded indications of violations directly on the graphical display of the digital dental model <NUM> itself to visually show the operator user where the violations are occurring to help inform the operator how to further modify or manipulate the dentition adjustment <NUM> to avoid the interference.

However, even with efforts to avoid introducing interference by accounting for interferences caused by the dentition adjustment <NUM>, changes can occur in the patient's jaw motion as a result of the dentition adjustment <NUM>. Such changes in jaw motion can also result in undesirable interference. Therefore, to further bolster efforts to avoid introducing interference, the changes occurring to the patient's jaw motion as a result of the dentition adjustment <NUM> can also be accounted for by predicting, by the motion analyzer <NUM>, a motion adjustment based on the dentition adjustment <NUM>. In some embodiments, the motion analyzer <NUM> analyzes the DTP model <NUM>, along with the motion data <NUM>, to predict what changes will occur in the patient's jaw motion as a result of the dentition adjustment <NUM>, and then analyzes the DTP model <NUM> based on the predicted changes in the patient's jaw motion to generate analysis data <NUM>.

Various embodiments can be implemented by the motion analyzer <NUM> to predict the motion adjustment. In one or more of the embodiments, a location of a screw axis of the patient's jaw is determined. The screw axis corresponds to the condyloid process of the temporomandibular joint of the patient, and is an axis about which the lower jaw rotates and translates along. Accordingly, the location of the screw axis imposes limitations on a range of motion of the jaw. Mathematical coordinates of the range of motion relative to the patient's dentition can be determined and used as parameters for simulating the motion of the jaw after the dentition adjustment <NUM> is made. Other jaw-related characteristics or parameters, such as a flexibility or "sponginess" of the temporomandibular joint, can be determined and used as data input for simulating the motion of the jaw. For example, the DTP model <NUM> that includes the dentition adjustment <NUM> can be used in conjunction with the screw axis location and other j aw-related parameters to simulate the motion of the jaw after the dentition adjustment <NUM>.

In one embodiment, the motion adjustment prediction is determined via a simulation guided by manual inputs and manipulations of a user, such as the dentist D, to a digital articulator. For example, the digital articulator can be displayed through a user interface of a computing device and the dentist D can interact with the digital articular using input devices of the computing device, such as a touch input device, a mouse, a keyboard, or a joystick, among other input devices. In some embodiments, the digital articulator includes the DTP model <NUM> defining the dentition adjustment <NUM>, and the user can use the input devices to manually shift the lower jaw of the DTP model <NUM> within the simulation. The lower jaw is manually shifted up and down, forward and back, and side to side to collect analysis data <NUM> within the range of motion permitted by the screw axis location and other jaw-related characteristics or parameters for determining whether an interference present in the pre-treatment dentition that restricted the motion of the jaw has been removed as a result of the dentition adjustment <NUM> defined in the DTP model <NUM>. For example, a post-dentition adjustment interference boundary <NUM> is determined by the interference boundary generator <NUM> based on analysis data <NUM> collected during the manual shifting, and can be compared to the pre-treatment interference boundary <NUM> to determine whether an interference has been removed.

In another embodiment, the motion adjustment prediction is determined via a simulation employing artificial intelligence to perform automated shifting of the lower jaw of the DTP model <NUM> within the digital articulator. For example, the lower jaw within the above-described simulation is automatically shifted up and down, forward and back, and side to side within the range of motion permitted by the screw axis location and other jaw-related characteristics or parameters to collect analysis data <NUM> for determining whether an interference present in the pre-treatment dentition that restricted the motion of the jaw has been removed as a result of the dentition adjustment <NUM> defined in the DTP model <NUM>. Similarly, the post-dentition adjustment interference boundary <NUM> is determined by the interference boundary generator <NUM> based on analysis data <NUM> collected during the automatic shifting, and can be compared to the pre-treatment interference boundary <NUM> to determine whether an interference has been removed.

In further embodiments, utilizing the DTP model <NUM> that includes the dentition adjustment <NUM> as well as the range of motion limitations designated by the determined screw axis location and other jaw-related characteristics or parameters, data points are recorded at a plurality of different three dimensional points within an xyz space to determine one or more directions and a magnitude thereof that each tooth of the dentition moves as the lower jaw of the DTP model <NUM> is moved within the xyz space to predict the post-dentition adjustment interference boundary <NUM>. For example, a reference point may be selected within the jaw. From the reference point, a direction and magnitude in which each tooth is able to move is measured as the jaw is moved (e.g., up and down, side to side, and front to back) every n millimeters, for example. In some embodiments, the measurements are relative to a pitch, a yaw, and a roll of the jaw. The analysis data <NUM> comprises the recorded data points, which are utilized by the interference boundary generator <NUM> to determine the post-dentition adjustment interference boundary <NUM>, which can be compared to the pre-treatment interference boundary <NUM> to determine whether an interference has been removed.

The 3D modeling system <NUM> can then modify the dental treatment plan <NUM> as needed to accommodate for the predicted motion adjustment (e.g., to ensure that the dentition adjustment <NUM> made does not go beyond the confines of or violate the predicted post-dentition adjustment interference boundary <NUM>). The 3D modeling system <NUM> can correspondingly adjust the DTP model <NUM> to generate a modified DTP model <NUM>. The modified DTP model <NUM> is then provided as output of the treatment plan generator <NUM>.

<FIG> illustrates an exemplary architecture of a computing device <NUM> that can be used to implement aspects of the present disclosure, including any of the plurality of computing devices described herein, such as a computing device of the patient evaluation system <NUM>, the scanner <NUM>, the motion capture station <NUM>, the treatment plan generation system <NUM>, the interference boundary generator <NUM>, the treatment plan generator <NUM>, the 3D modeling system <NUM>, the interference checker <NUM>, the motion analyzer <NUM>, the rapid fabrication machine <NUM>, the restoration fabrication station <NUM>, or any other computing devices that may be utilized in the various possible embodiments.

The computing device illustrated in <FIG> can be used to execute the operating system, application programs, and software modules (including the software engines) described herein.

The computing device <NUM> includes, in some embodiments, at least one processing device <NUM>, such as a central processing unit (CPU). A variety of processing devices are available from a variety of manufacturers, for example, Intel or Advanced Micro Devices. In this example, the computing device <NUM> also includes a system memory <NUM>, and a system bus <NUM> that couples various system components including the system memory <NUM> to the processing device <NUM>. The system bus <NUM> is one of any number of types of bus structures including a memory bus, or memory controller; a peripheral bus; and a local bus using any of a variety of bus architectures.

Examples of computing devices suitable for the computing device <NUM> include a desktop computer, a laptop computer, a tablet computer, a mobile computing device (such as a smart phone, an iPod® or iPad® mobile digital device, or other mobile devices), or other devices configured to process digital instructions.

The system memory <NUM> includes read only memory <NUM> and random access memory <NUM>. A basic input/output system <NUM> containing the basic routines that act to transfer information within computing device <NUM>, such as during start up, is typically stored in the read only memory <NUM>.

The computing device <NUM> also includes a secondary storage device <NUM> in some embodiments, such as a hard disk drive, for storing digital data. The secondary storage device <NUM> is connected to the system bus <NUM> by a secondary storage interface <NUM>. The secondary storage device <NUM> and their associated computer readable media provide nonvolatile storage of computer readable instructions (including application programs and program modules), data structures, and other data for the computing device <NUM>.

Although the exemplary environment described herein employs a hard disk drive as a secondary storage device, other types of computer readable storage media are used in other embodiments. Examples of these other types of computer readable storage media include flash memory cards, digital video disks, compact disc read only memories, digital versatile disk read only memories, random access memories, or read only memories. Some embodiments include nontransitory media. Additionally, such computer readable storage media can include local storage or cloud-based storage.

A number of program modules can be stored in secondary storage device <NUM> or system memory <NUM>, including an operating system <NUM>, one or more application programs <NUM>, other program modules <NUM> (such as the software engines described herein), and program data <NUM>. The computing device <NUM> can utilize any suitable operating system, such as Microsoft Windows™, Google Chrome™ OS, Apple OS, Unix, or Linux and variants and any other operating system suitable for a computing device. Other examples can include Microsoft, Google, or Apple operating systems, or any other suitable operating system used in tablet computing devices.

In some embodiments, a user provides inputs to the computing device <NUM> through one or more input devices <NUM>. Examples of input devices <NUM> include a keyboard <NUM>, mouse <NUM>, microphone <NUM>, and touch sensor <NUM> (such as a touchpad or touch sensitive display). Other embodiments include other input devices <NUM>. The input devices are often connected to the processing device <NUM> through an input/output interface <NUM> that is coupled to the system bus <NUM>. These input devices <NUM> can be connected by any number of input/output interfaces, such as a parallel port, serial port, game port, or a universal serial bus. Wireless communication between input devices and the input/output interface <NUM> is possible as well, and includes infrared, BLUETOOTH® wireless technology, IEEE <NUM>. 11a/b/g/n, cellular, ultra-wideband (UWB), ZigBee, LoRa, or other radio frequency communication systems in some possible embodiments.

In this example embodiment, a display device <NUM>, such as a monitor, liquid crystal display device, projector, or touch sensitive display device, is also connected to the system bus <NUM> via an interface, such as a video adapter <NUM>. In addition to the display device <NUM>, the computing device <NUM> can include various other peripheral devices (not shown), such as speakers or a printer.

When used in a local area networking environment or a wide area networking environment (such as the Internet), the computing device <NUM> is typically connected to the network through a network interface <NUM>, such as an Ethernet interface. Other possible embodiments use other communication devices. For example, some embodiments of the computing device <NUM> include a modem for communicating across the network.

The computing device <NUM> typically includes at least some form of computer readable media. Computer readable media includes any available media that can be accessed by the computing device <NUM>. By way of example, computer readable media include computer readable storage media and computer readable communication media.

Computer readable storage media includes volatile and nonvolatile, removable and non-removable media implemented in any device configured to store information such as computer readable instructions, data structures, program modules or other data. Computer readable storage media includes, but is not limited to, random access memory, read only memory, electrically erasable programmable read only memory, flash memory or other memory technology, compact disc read only memory, digital versatile disks or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store the desired information and that can be accessed by the computing device <NUM>.

Computer readable communication media typically embodies computer readable instructions, data structures, program modules or other data in a modulated data signal such as a carrier wave or other transport mechanism and includes any information delivery media. The term "modulated data signal" refers to a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, computer readable communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, radio frequency, infrared, and other wireless media. Combinations of any of the above are also included within the scope of computer readable media.

The computing device illustrated in <FIG> is also an example of programmable electronics, which may include one or more such computing devices, and when multiple computing devices are included, such computing devices can be coupled together with a suitable data communication network so as to collectively perform the various functions, methods, or operations disclosed herein.

<FIG> is a flow chart illustrating an example method <NUM> of predicting a motion adjustment responsive to a restoration preparation. In this example, the method <NUM> includes operations <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>. Example dental procedures involving dentition adjustments may include dental restorations and dental alignment. The first example is illustrated and described in more detail with reference to <FIG>, and the second example is illustrated and described in more detail with reference to <FIG>.

Often, dental restorations involve two steps: preparation of the tooth or teeth for placement of restorative materials (i.e., a restoration preparation) and the placement of the restorative materials. Example dental restorations include dental implants, bridges, and/or crowns, among other similar dental procedures. The example method <NUM> can be implemented by various components of the patient evaluation system <NUM> described above with reference to <FIG>.

At operation <NUM>, a scan <NUM> of dentition is performed prior to the preparation and/or placement of the restorative materials. Based on the scan <NUM>, a position and orientation of each tooth in the upper and lower dental arches of the dentition is determined with respect to each other tooth. At operation <NUM>, a dentition motion assessment <NUM> is performed. The dentition motion assessment <NUM> captures a representation of the movement of the dental arches relative to each other. For example, the dentition motion assessment <NUM> captures how each tooth in the upper and lower dental arches move with respect to one another.

An interference boundary prior to the restoration preparation (e.g., a pre-treatment interference boundary <NUM>) can be determined from the scan <NUM> and the dentition motion assessment <NUM>. The pre-treatment interference boundary <NUM> is a boundary of function between teeth of the dental arch on the upper jaw and teeth of the opposing dental arch on the lower jaw, and is defined by the interface or interaction between teeth on opposing dental arches. For example, the pre-treatment interference boundary <NUM> indicates how far each particular tooth can vertically, anteroposteriorly, and transversely. If a tooth extends or crosses over the pre-treatment interference boundary in one or more planes, an interference with teeth of the opposing dental arch of the dentition is created.

At operation <NUM>, a restorative material and a restoration preparation are determined. The restoration preparation can involve a removal and/or shaping of one or more portions of a tooth or teeth. In one example, the restoration preparation is a crown preparation that involves grinding off a top part of the tooth to replace with a crown. In another example, the restoration preparation is a bridge preparation that involves grinding off a top part of multiple teeth to replace with a bridge. In a further example, the restoration preparation is a dental implant preparation that involves removal of the entire tooth to be replaced with an implant.

In some examples, the restoration preparation is determined using the scan <NUM>, data from the dentition motion assessment <NUM>, and the determined pre-treatment interference boundary <NUM>. For example, a position and orientation of a tooth associated with the restoration is visualized using the scan <NUM> and motion data <NUM> to determine how the tooth associated with the restoration preparation can move vertically, anteroposteriorly, and transversely ensure that the how the tooth is prepared (e.g., what portions of the tooth are being removed or how the tooth is shaped) does not move or adjust the tooth beyond the confines of or violate the pre-treatment interference boundary <NUM> to avoid introducing an interference.

The determination of the restorative material includes determining a type of material to use to replace or cover the one or more portions of the tooth or teeth removed and/or shaped in the restoration preparation. Based on a type of the restoration preparation, certain types of restorative material can be more advantageous to use due to the properties of the materials, such as a durability of the material or a malleability of the material. A size of the material, including a thickness of material, can also be determined.

At operation <NUM>, a motion adjustment based on the restoration preparation is predicted. As one example, if the restoration preparation determined at operation <NUM> is a crown preparation that will require the cutting or grinding down of a tooth or set of teeth, the additional space provided by the crown preparation may actually modify the patient's bite and jaw motion by removing an interference that had been previously restricting the motion of the jaw. This modification to the bite and jaw motion may result in the need to further modify the restoration preparation and/or restorative materials determined at operation <NUM> to avoid interferences resulting from the modifications. For example, the jaw can now move more freely in one or more directions causing the teeth to move relative to one another in different ways (e.g., a particular tooth can now move further vertically, anteroposteriorly, or transversely). Accordingly, the motion adjustment can affect the pre-treatment interference boundary <NUM>.

Therefore, to predict the motion adjustment, a determination is made as to whether an interference will be removed after the restoration preparation, and if so, associated effects of the removal by predicting a post-preparation interference boundary. The post-preparation interference boundary is defined by the interface or interaction between the teeth on the opposing dental arches after the restoration preparation is performed. In some examples, the post-preparation interference boundary can be compared to the pre-treatment interference boundary <NUM> to measure a change that has occurred, where the change (e.g., a net reduction) between the two interference boundaries can be used to determine whether the dentition has been sufficiently prepared for the placement of the restorative material. Continuing the above example of a crown preparation, a particular amount of reduction (e.g., cutting or grinding down of the tooth) is required so that a restorative material of a sufficient thickness (e.g., for stability) can be placed over the prepared tooth without causing interference. In other words, the particular amount of reduction during preparation with placement of the sufficiently thick restorative material thereon meets a required clearance to avoid interference.

At decision <NUM>, a determination is made as to whether the restorative material and the restoration preparation cause an interference based on the predicted motion adjustment. The determination can be made based on the measured change between the pre-treatment interference boundary <NUM> and the post-preparation interference boundary predicted discussed above in conjunction with operation <NUM>. As previously discussed, dental restoration involves two steps: preparation of the tooth for placement of restorative materials (i.e., restoration preparation) and the placement of the restorative materials. Restoration preparation includes a change to a structure or shape of a tooth or teeth. For example, grinding down a tooth to a certain size and shape, so that it may be covered with restorative material (e.g. a crown) or extracting one or more teeth for installation of a dental implant or a bridge. As described above with respect to operation <NUM>, the restoration preparation and restorative materials are determined based on the pre-treatment interference boundary <NUM> to avoid introducing interference. For example, the restoration preparation and restorative materials are initially determined to meet a required clearance, which ensures a proper fit enabling the patient P to maintain a same or similar bite pre-treatment and post-dentition adjustment (e.g., a tooth and restorative material when placed over the tooth does not extend or cross over the pre-treatment interference boundary <NUM> in one or more planes to avoid introducing interference). However, any adjustments to the motion of the jaw resulting from the restoration preparation of the tooth (e.g., due to a removal of an interference) can correspondingly impact how the tooth should be prepared and/or how the restorative materials should be placed. For example, if an interference is removed by the restoration preparation and the motion of the jaw changes, the required clearance could either increase or decrease in size due to a change in the pre-treatment interference boundary <NUM>, and the restoration preparation and restorative materials may no longer avoid interference. As one example, when the changes in jaw motion cause the required clearance to decrease in size (e.g., when a space in which the restorative material placed over the prepared tooth is designed to fit has decreased), a vertical height of the restorative material, such as a crown, may now be too tall for the space causing a new interference with opposing teeth.

If the restorative material and the restoration preparation do not cause an interference based on the predicted motion adjustment (e.g., based on the measured change between the pre-treatment interference boundary <NUM> and the post-preparation interference boundary), the restoration preparation is performed and the restorative material is placed (not claimed) at operation <NUM>. For example, the portions of the tooth are removed and/or shaped according to the initial restoration preparation determined, and the portions removed can be replaced with the initial restorative materials determined.

If the restorative material and the restoration preparation cause an interference based on the predicted motion adjustment (e.g., based on the measured change between the pre-treatment interference boundary <NUM> and the post-preparation interference boundary), one or more of the restorative material and the restoration preparation are modified at operation <NUM>. For example, the restoration preparation and/or restorative material are modified to correspond to the predicted post-preparation interference boundary. In one embodiment, a size or a thickness of the restorative material can be modified or a different type of restorative material can be used. For example, if it is predicted that the restoration preparation will remove an interference and cause a motion adjustment of the jaw that lowers a height of clearance for the restorative materials being placed (e.g., the motion adjustment brings upper and lower dentition closer together leaving less space for the restorative material), a size or thickness of the restorative material is reduced. However, in some cases, properties of the restorative material cannot be reduced below a certain size or thickness and thus a new restorative material will be selected. In another embodiment, the restoration preparation itself is adjusted. For example, a tooth being prepared can be ground or cut down to a different height or shape that will enable the restorative material to be placed. In a further embodiment, both the restorative material and the restoration preparation are modified.

In additional embodiments, when the restoration preparation includes a crown preparation and the restorative material is a crown, the crown can be automatically generated to account for the motion adjustment. For example, an occlusal surface of the crown may be generated digitally to correspond with the predicted post-preparation interference boundary. In some embodiments, a default crown structure is used as a starting template that is then adjusted and contoured based on the predicted post-preparation interference boundary. Specifically, the predicted post-preparation interference boundary is used to define contoured portions of the crown surface that interface with opposing and adjacent teeth to prevent introducing interference. For example, based on the predicted post-preparation interference boundary, one or more rules or parameters are generated to ensure that the boundary is not violated in any plane by the crown as it is being digitally generated. In some examples, the rules or parameters may be associated with a slope of the sidewalls of the crown, in addition to a height and shape of the crown.

In some embodiments, the operations <NUM>, <NUM>, and <NUM> can be repeated one or more times until the restorative material and the restoration preparation do not cause an interference. The process can be iteratively repeated to modify the restorative material or restoration preparation, predict motion based on the modified restoration preparation, and further modify the restorative material or restoration reparation based on whether the restorative material and restoration preparation cause an interference based on the predicted motion.

<FIG> is a flow chart illustrating an example method <NUM> of predicting a motion adjustment responsive to a dental alignment plan. The dental alignment plan involves adjustment of position and/or alignment of the teeth in three planes of space, which can be accomplished using braces, retainers, or other dental alignment tools. The example method <NUM> can be implemented by various components of the patient evaluation system <NUM> described above in <FIG>. In this example, the method <NUM> includes operations <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>.

At operation <NUM>, a scan <NUM> of dentition is performed. Based on the scan <NUM>, a position and orientation of each tooth in the upper and lower dental arches is determined with respect to each other tooth. At operation <NUM>, a dentition motion assessment <NUM> is performed. The dentition motion assessment <NUM> captures a representation of the movement of the dental arches relative to each other. For example, the dentition motion assessment <NUM> captures how each tooth in the upper and lower dental arches move with respect to one another. The movement is captured as motion data <NUM>.

Using the scan <NUM> and motion data <NUM>, an interference boundary prior to the dental alignment (e.g., a pre-treatment interference boundary <NUM>) can be determined. The pre-treatment interference boundary <NUM> is a boundary of function between teeth of the dental arch on the upper jaw and teeth of the opposing dental arch on the lower jaw, and is defined by the interface or interaction between teeth on opposing dental arches. For example, the pre-treatment interference boundary <NUM> indicates how far a particular tooth can move vertically, anteroposteriorly, and transversely. If a tooth extends or crosses over the pre-treatment interference boundary <NUM> in one or more planes, an interference with teeth of the opposing dental arch of the dentition is created.

At operation <NUM>, a dental alignment plan is determined using the scan <NUM> of the dentition, motion data <NUM> from the dentition motion assessment <NUM>, and the pre-treatment interference boundary <NUM>. For example, utilizing the scan <NUM> and motion data <NUM>, a position and orientation of a tooth associated with the alignment and how the tooth can move vertically, anteroposteriorly, and transversely can be visualized to ensure that how the tooth is aligned (e.g., a direction or orientation of the alignment) does not move or adjust the tooth beyond the confines of the pre-treatment interference boundary <NUM> to avoid introducing an interference.

At operation <NUM>, a motion adjustment based on the dental alignment plan is predicted. As one example, if the dental alignment plan determined at operation <NUM> involves straightening a crooked tooth, the new position and orientation of the straight tooth can cause the patient's bite and jaw motion to change. This change to the bite and jaw motion may result in the need to further modify the dental alignment plan determined at operation <NUM> to avoid interferences resulting from the changes. For example, the motion of the jaw may be more restricted in one or more directions causing the teeth to move relative to one another in different ways. For example, the tooth once straightened can no longer move as far vertically, anteroposteriorly, or transversely before interfacing with opposing teeth. Accordingly, the motion adjustment can affect the pre-treatment interference boundary <NUM>.

Therefore, to predict the motion adjustment, a determination is made as to whether an interference will be removed or created following the dental alignment and if so, associated effects of the removal by predicting a post-alignment interference boundary (e.g., the interference boundary after the dental alignment). The post-alignment interference boundary is defined by the interface or interaction between the teeth on the opposing dental arches after the dental alignment.

At operation <NUM>, an interference is identified and analyzed based on the predicted motion adjustment. For example, in some embodiments, the interference is identified and analyzed by comparing the pre-treatment interference boundary <NUM> to the post-alignment interference boundary.

At operation <NUM>, the dental alignment is modified to reduce the interference. For example, the dental alignment plan is modified and the modified dental alignment can be further analyzed to see if the interference has been removed. If not, the plan can be iteratively modified until the interference has been eliminated or is less than a predetermined threshold amount. For example, the operations <NUM>, <NUM>, and <NUM> can be repeated one or more times to adjust the dental alignment, predict motion based on the adjusted dental alignment, identify and analyze interference based on the predicted motion, and further adjust the dental alignment based on identified interference until interference is eliminated, or until the interference is less than a predetermined amount. Once the interference is eliminated, or the interference is less than the predetermined amount, the dental alignment can be performed according to the adjusted dental alignment at operation <NUM>.

Claim 1:
A computer-implemented method of analyzing a dental treatment plan, the method comprising:
performing (<NUM>) a scan of dentition;
generating a digital dental model from the scan of the dentition, the digital dental model representing a position and an orientation of each tooth in upper and lower dental arches of the dentition with respect to each other tooth;
performing (<NUM>) a dentition motion assessment by capturing motion data, the motion data representing a movement of upper and lower dental arches of the dentition relative to each other;
determining a pre-treatment interference boundary based on the scan and the dentition motion assessment, wherein the pre-treatment interference boundary is a boundary of function between opposing teeth of upper and lower dental arches prior to implementing the dental treatment plan, and is defined by an interface or interaction between the opposing teeth;
determining (<NUM>) a dental treatment plan with a dentition adjustment based on the scan, the digital dental model, the pre-treatment interference surface boundary, and the dentition motion assessment to avoid introducing interferences between the opposing teeth;
predicting (<NUM>) a motion adjustment based on the dentition adjustment; and modifying (<NUM>) the dental treatment plan based on the predicted motion adjustment; and wherein predicting (<NUM>) the motion adjustment based on the dentition adjustment comprises:
determining a location of a screw axis about which a lower jaw rotates and translates along;
determining one or more other jaw-related parameters; and
simulating a range of motion of the lower jaw within a digital dental model that includes the dentition adjustment, the range of motion based on the location of the screw axis and the one or more other jaw-related parameters.