Patent Description:
The dental restoration of a partially or wholly edentulous patient with artificial dentition is typically done in two stages. In the first stage, an incision is made through the gingiva to expose the underlying bone. After a series of drill bits creates an osteotomy in the bone, a dental implant is placed in the jawbone for integration. The dental implant generally includes a threaded bore to receive a retaining screw holding mating components therein. During the first stage, the gum tissue overlying the implant is sutured and heals as the osseointegration process continues.

Once the osseointegration process is complete, the second stage is initiated. Here, the gum tissue is re-opened to expose the end of the dental implant. A healing component or healing abutment is fastened to the exposed end of the dental implant to allow the gum tissue to heal therearound. Preferably, the gum tissue heals such that the aperture that remains generally approximates the size and contour of the aperture that existed around the natural tooth that is being replaced. To accomplish this, the healing abutment attached to the exposed end of the dental implant has the same general contour as the gingival portion of the natural tooth being replaced.

During the typical second stage of dental restoration, the healing abutment is removed and an impression coping is fitted onto the exposed end of the implant. This allows an impression of the specific region of the patient's mouth to be taken so that an artificial tooth is accurately constructed. After these processes, a dental laboratory creates a prosthesis to be permanently secured to the dental implant from the impression that was made.

In addition to the more traditional system for placing dental implants described above, some systems use guided placement of the dental implants. To do so, a surgical guide is placed in the patient's mouth at the known location. The surgical guide includes openings for providing the exact placement of the drill bits used to create the osteotomy. Once the osteotomy is completed, the surgical guide may permit the dental implant to be placed through the same opening and enter the osteotomy that was guided by the surgical guide.

Surgical guides can be created by the use of a CT-scan of the patient's mouth. The CT-scan provides enough detail to develop the surgical guide by use of various methods. For example, a CT-scan can provide the details of the patient's gum tissue and/or remaining teeth so that the surgical guide can be developed based on computer-aided design (CAD) and computer-aided manufacturing (CAM).

However, with digital design and the manufacture of the physical surgical guide a need exits to determine that the physical surgical guide matches the virtually designed surgical guide.

A relevant prior art is examplified by <CIT> and <CIT> which disclose a checking suport including a calibration member.

Disclosed herein is a system for checking the accuracy of a manufactured surgical guide. For example, during virtual planning, the virtual surgical guide includes master tubes having an axis that is the axis that a dental implant will be installed. The virtual surgical guide can be manufactured, e.g., by subtractive methods and additive methods. Subtractive methods include milling and additive methods can include rapid prototyping techniques such as: stereolithography, laminated-object manufacturing, selective laser sintering, solid ground curing, or other known rapid prototyping processes.

According to the present disclosure, once the virtual surgical guide design is completed, manufacturing data is sent for the physical surgical guide to be fabricated. Once fabricated the master tubes can be inserted within the physical surgical guide. However, manufacturing errors or errors while inserting the master tubes can potentially offset the axis of the master tubes such that the axis of the master tubes within the physical surgical guide no longer match the axis of the maters tubes in the virtually designed surgical guide. Additionally, once the virtual design is complete, a check protocol form is also developed and sent to a traditional paper printer. As discussed herein, the physical surgical guide including the master tubes and the check protocol form can be combined to determine the accuracy of the physical surgical model.

Also according to the present disclosure, the accuracy of the physical surgical guide can be checked digitally. For example, once the physical surgical guide is manufactured and the master tubes are inserted, scan bodies are attached to each master tube. The physical surgical guide with the scan bodies are scanned to obtain digital scan data of the physical surgical guide. The scan bodies allow the location and orientation of the master tubes to be determined. For example, an axis of the master tubes can be determined from that scan data including the scan bodies. The method can include merging the virtually designed surgical guide with the scan data of the physical surgical guide with the scan bodies and determine whether the axis of the master tubes in the physical surgical guide match the axis of the master tubes in the virtually designed guide.

These and other examples, advantages, and features of the present dental membranes will be set forth in part in the following Detailed Description and the accompanying drawings. This Overview is intended to provide non-limiting examples of the present subject matter-it is not intended to provide an exclusive or exhaustive explanation. The Detailed Description and drawings are included to provide further information about the present porous metal dental implants.

The above-mentioned and other features and advantages of this disclosure, and the manner of attaining them, will become more apparent and will be better understood by reference to the following description of embodiments of the disclosure taken in conjunction with the accompanying drawings.

The present invention provides a system for checking the accuracy of a manufactured surgical guide. For example, during virtual planning, the virtual surgical guide includes master tubes having an axis that is the axis that a dental implant will be installed. The virtual surgical guide can be manufactured, e.g., by subtractive methods and additive methods. As discussed herein, the accuracy of the physical surgical guide can be checked physically or virtually.

<FIG> illustrates a physical surgical guide <NUM> including a body <NUM> and master tubes <NUM>. The surgical guide <NUM> can be produced from various materials and techniques. One preferred method is using a rapid-prototyping technique based on the scanned images within the patient's mouth. In the example, there is a need for six implants on the top jaw 10A and six implant on the bottom jaw 10B, thus, the surgical guide10 includes six opening on the top jaw surgical guide 10A and six opening on the bottom jaw surgical guide 10B, each of which is defined by a master tube <NUM> that is integrated into the material of the surgical guide <NUM> with the assistance of the outer roughened surface and adhesive. The master tubes <NUM> are located on flat surfaces that are substantially flush with the top surface of the master tubes <NUM>. The under portion of the surgical guide (not visible in <FIG>) has a contour that follows the scanned gingival surface in the patient's mouth. In other words, the under portion of the surgical guide <NUM> is a negative impression of the gingival surface. The surgical guide also includes a plurality of openings <NUM> through which temporary fixation screws <NUM> or pins can be placed. The temporary fixation screws or pins engage the bone and hold the surgical guide <NUM> in the proper location on the gingival surface so that the dental plan can be executed using the surgical guide <NUM>. As mentioned previously, the surgical guide <NUM> can also be a negative impression of the surface of adjacent teeth and bone tissue in some situations and rest against the adjacent teeth and bone tissue. Examples of fabricating surgical guides can be found in <CIT>.

<FIG> illustrate the virtually designing of the surgical guide and location and orientation of dental implant. As seen in <FIG>, the location of the dental implants is determined. As seen in <FIG>, the display includes a virtual representation of the patient's mouth, a virtual surgical guide and the axis <NUM> along with the dental implant is inserted into the virtual model.

Once the surgical plan including the surgical guide having master tubes is finalized, manufacturing information is sent to a fabrication machine, e.g., a rapid prototyping machine. As seen in <FIG>, a physical surgical guide <NUM> has been formed. The physical surgical guide <NUM> includes openings <NUM> that are configured to receive master tubes <NUM> (<FIG>), opening <NUM> that are configured to receive the fixation pins <NUM> (<FIG>), and a check booth attachment flange <NUM> including opening. A user would couple the master tubes <NUM> to the surgical guide <NUM>. Along with manufacturing the surgical guide <NUM>, a check protocol form <NUM> is also produced and sent to a traditional paper printer. The check protocol form <NUM> includes a calibration check points <NUM> that is configured to determine whether the dimensions of the check protocol form <NUM> are accurate. The form <NUM> further includes pointes <NUM> that correspond to the axis along which each implant is to be installed along and in relation to each other. The point <NUM> includes a center point <NUM> corresponding to the axis along which each implant is to be installed as well as a circle <NUM> surrounding the center point <NUM>. The circle <NUM> defines the acceptable tolerance of the axis of the surgical guide. As discussed herein, during the checking procedure a pin must be within the circle <NUM> for that particular master tube to pass inspection.

<FIG> illustrates a check booth <NUM> that is configured to receive the form <NUM>. The booth <NUM> includes a support surface <NUM> and a checking support <NUM> coupled to the support surface <NUM>. The checking support <NUM> is moveable such that the support <NUM> can be lifted such that the form <NUM> can be inserted on the support surface <NUM> (see <FIG>). To secure the form <NUM> to the check booth <NUM>, the check support <NUM> can be biases towards the support surface <NUM> (e.g., a biasing member) such that pressure is placed on the form <NUM> thereby securing the form <NUM> to the booth <NUM>. The checking support <NUM> includes a calibration member <NUM> defining openings <NUM>. As seen in <FIG>, the calibration member <NUM> and openings <NUM> align with the calibration check points <NUM> on the form <NUM>. A distance between the openings <NUM> should match a distance between the calibration check points <NUM> to confirm that the dimensions of the form <NUM> match the dimensions of the virtual surgical plan. <FIG> illustrates calibration pins <NUM> inserted through the openings <NUM>. As seen in <FIG>, the tip of the calibration pins <NUM> are within the calibration check points <NUM> thus confirming the dimensions of the form <NUM> are accurate.

The check booth <NUM> further includes a support structure <NUM> to couple the physical surgical guide to the check booth <NUM>. As seen in <FIG>, the support structure <NUM> includes openings <NUM> through which engagement pins <NUM> are inserted. <FIG> illustrates the physical surgical guide <NUM> including the master tubes <NUM> coupled to the check booth <NUM> via engagement pins <NUM> that extend through openings <NUM> of the surgical guide <NUM>.

<FIG> illustrates a plurality of check pins <NUM> extending through each master tube of the surgical guide. <FIG> illustrates a close-up a pin <NUM>. A tip of the pin <NUM> is shown being positioned within the circle <NUM> of the point <NUM>. In on example, a user can visually verify if the tip <NUM> is within the circle <NUM> of each point <NUM>. In another example, the tip <NUM> can be configured to leave a mark on the form <NUM> thus a user can not only visually but also verify once the pins <NUM> are removed to see if the indentation or mark provided by the pin <NUM> is within the circle <NUM>.

<FIG> illustrates <FIG> without the surgical guide body <NUM> for simplicity. As seen in <FIG>, each pin <NUM> is within the point <NUM> corresponding to an axis of an implant in the surgical plan. Again, the pins represent the axis formed by the master tubes. Thus, in order to confirm the accuracy of the physical surgical guide, the axis of the pins <NUM> need to align within a certain tolerate of the axis of the implant in the surgical plan.

<FIG> illustrates a completed check form <NUM> that includes accuracy check boxes <NUM> for each implant to be installed in a patient according to a surgical plan. If each check box <NUM> is marked for accuracy a final accuracy check box <NUM> can be marked. The physical surgical guide is now acceptable for use on a patient. If one of the pins does not align with the available tolerance, a user would select the faulty check box and a new surgical guide would need to be manufactured.

The devices and methods discussed above relate to physically checking the accuracy of the physical surgical guide. As discussed herein, the accuracy can also be check digitally. In that instance, after the physical surgical guide is manufactured a scanning body can be coupled to each master tube. <FIG> is a cross-section of a portion of the physical surgical guide <NUM> including the master tube <NUM>. As seen in <FIG>, a scanning body <NUM> can be coupled to the master tube <NUM>. Various scanning bodies are contemplated, and the scan body only need to be accurately coupled to the surgical guide such that a central axis of the master tube can be determined. Thus, sufficient seating of the scanning body <NUM> is necessary. In one example, a top surface <NUM> of the master tube is configured to engage with a seating surface <NUM> of the scanning body <NUM>. While the scan body <NUM> can simply sit on the master tube, some embodiments include placing the surgical guide on a scanning support <NUM> where the scanning support <NUM> can have a threaded opening <NUM> that can engage with a threaded surface of the scan body. Thus, the scan body <NUM> can be threaded into the scanning support <NUM> to securely hold the scanning body <NUM> to the surgical guide <NUM> for better accuracy.

Once the scan bodies <NUM> are coupled, the surgical guide <NUM> including the scan bodies <NUM> are scanned. A virtual representation of the physical guide <NUM> including the scan bodies <NUM> can be determined. Based on the scan body, a user can modify the virtual representation such that an axis <NUM> of the master tubes <NUM> can be virtually depicted. The scan data illustrates the axis <NUM> of the master tubes <NUM> can be compared to the axis of the implant in the surgical plan and determine if they align.

Having described a method of designing and checking the accuracy of the physical surgical guide with the surgical plan, the present disclosure also includes a computer system that may be employed in accordance with at least some of the example embodiments herein. Although various embodiments may be described herein in terms of this exemplary computer system, after reading this description, it may become apparent to a person skilled in the relevant art(s) how to implement the disclosure using other computer systems and/or architectures.

The computer system may include a scanner such as CBCT, MRI and/or intra-oral scanner for obtaining 3D images of the dental cavity. The computer system may also include at least one computer processor. The computer system may be configured to receive the 3D images and the processor may be configured to analyze said 3D images in order to create the rendering of the patient which may be displayed on a display of the computer system. In an embodiment herein the computer system may take input from a clinician through an input unit such as a keyboard, mouse, touchscreen monitor or the like in order to create the surgical plan.

A display interface (or other output interface) may forward video graphics, text, and other data from the communication infrastructure (or from a frame buffer (not shown)) for display on the display unit.

One or more steps of creating the surgical plan and checking the accuracy of the physical surgical guide may be stored on a non-transitory storage device in the form of computer-readable program instructions. To execute a procedure, the processor loads the appropriate instructions, as stored on the storage device, into memory, and then executes the loaded instructions.

The computer system may also comprise a main memory, which may be a random-access memory ("RAM"), and also may include a secondary memory. The secondary memory may include, for example, a hard disk drive and/or a removable-storage drive (e.g., a floppy disk drive, a magnetic tape drive, an optical disk drive, a flash memory drive, and the like). The removable-storage drive may read from and/or write to a removable storage unit <NUM> in a well-known manner. The removable storage unit may be, for example, a floppy disk, a magnetic tape, an optical disk, a flash memory device, and the like, which may be written to and read from by the removable-storage drive. The removable storage unit may include a non-transitory computer-readable storage medium storing computer-executable software instructions and/or data.

In further alternative embodiments, the secondary memory may include other computer-readable media storing computer-executable programs or other instructions to be loaded into the computer system. Such devices may include a removable storage unit and an interface (e.g., a program cartridge and a cartridge interface); a removable memory chip and an associated memory socket; and other removable storage units and interfaces that allow software and data to be transferred from the removable storage unit to other parts of the computer system.

The computer system also may include a communications interface that enables software and data to be transferred between the computer system and external devices. Software and data transferred via the communications interface may be in the form of signals, which may be electronic, electromagnetic, optical or another type of signal that may be capable of being transmitted and/or received by the communications interface. Signals may be provided to the communications interface via a communications path (e.g., a channel). The communications path may carry signals and may be implemented using wire or cable, fiber optics, a telephone line, a cellular link, a radio-frequency ("RF") link, or the like. The communications interface may be used to transfer software or data or other information between the computer system and a remote server or cloud-based storage (not shown).

One or more computer programs or computer control logic may be stored in the main memory and/or the secondary memory. The computer programs may also be received via the communications interface. The computer programs may include computer-executable instructions which, when executed by the computer processor, cause the computer system to perform the methods described. Accordingly, the computer programs may control the computer system.

In another embodiment, the software may be stored in a non-transitory computer-readable storage medium and loaded into the main memory and/or the secondary memory of the computer system using the removable-storage drive , the hard disk drive, and/or the communications interface. Control logic (software), when executed by the processor, may cause the computer system, to perform all or some of the methods described herein.

Claim 1:
A check booth (<NUM>) system for use to determine the accuracy of a physical surgical guide (<NUM>) manufactured based on a virtual surgical plan including at least one virtual implant and a virtual surgical guide including at least one master tube (<NUM>), the check booth (<NUM>) comprising:
a support surface (<NUM>); and
a checking support (<NUM>) coupled to the support surface (<NUM>),
wherein the support surface (<NUM>) is configured to receive a check protocol form (<NUM>), and
wherein the checking support (<NUM>) includes a calibration member (<NUM>) having openings (<NUM>) and a support structure (<NUM>) configured to engage with the physical surgical guide (<NUM>).