Patent ID: 12251169

DETAILED DESCRIPTION OF THE DISCLOSURE

The present disclosure will now be described more fully hereinafter with reference to exemplary embodiments thereof. These exemplary embodiments are described so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art. Indeed, the disclosure is embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. The various aspects of the present disclosure previously mentioned, as well as many other aspects of the disclosure, are described in further detail herein.

Aspects of the present disclosure, as shown, for example, inFIG.1-4, involve a system100for relating an object200to a coordinate system300, as well as controlling a robot800with respect to an object200in a coordinate system300, wherein the object200is supported by a support element220, and wherein the object200and the support element220are housed within a housing240. In one example, the object200may include a tooth, the support element220may include the corresponding jaw and/or gums, and the housing240may include the mouth or maxillofacial structure of a patient. In one particular aspect, such a system100comprises a registration element170adapted to be engaged with the object200or the support element220(see, e.g.,FIG.2). An optical scanner400is arranged to conduct an optical surface scan of the object200(see, e.g.,FIGS.3and4) and the registration element170and to form a three-dimensional surface image (see, e.g.,FIG.6, right side image) of the object200. The optical scanner400is arranged to be hand held and manually manipulated by and operator (see, e.g.,FIG.1), or may otherwise be operably engaged with a distal end520of a robot tracking arm500(see, e.g.,FIG.1A). The three-dimensional surface image has the coordinate system300associated therewith, and the registration element170is associated with the coordinate system300. The registration element170adapted to be engaged with the object200or the support element220(see, e.g.,FIG.2) may comprise, for example, one or more fiducial markers175arranged to define or be in a known relation to the coordinate system300. More particularly, in some instances, the one or more fiducial markers175may be arranged such that at least the location and orientation of the one or more fiducial markers175is known or readily determinable in relation to or registration with the coordinate system300. A controller190has a processor, and is arranged to be in communication with the optical scanner400and, in some instances, with the robot tracking arm500. The controller190is further arranged to correlate the object200with the registration element170in the three-dimensional surface image so as to register the object200with the coordinate system300. That is, since the registration element170has one or more fiducial markers175that themselves define a known position/orientation or reference or registration in the coordinate system300, the optical surface scan of the object200/support element220including the registration element170allows the object200to be spatially correlated with registration element170based on the three-dimensional surface image. When the spatial correlation of the object200is known in relation to the registration element170and with respect to the coordinate system300, the object200thus becomes registered in the coordinate space300with respect to the registration element170.

In some instances, the system100may further include a computerized tomography device700(see, e.g.,FIG.5) arranged to conduct a radiographic scan of the housing240, and the object200and support element220housed therein, to form a radiographic image thereof (see, e.g.,FIG.6, left side image), prior to the registration element170being engaged with the object200or the support element220. In such instances, the controller190is arranged to be in communication with the computerized tomography device700to receive the imaging data, representing the radiographic scan/radiographic image, therefrom. Upon receipt of the imaging data, the controller190is further arranged to image-match the radiographic image of the object200with the three-dimensional surface image of the object200(see, e.g.,FIG.6) so as to form a correlated image of the object200in relation to the registration element170. Once the radiographic image and the three-dimensional surface image are correlated, the controller190is arranged to correlate the object200with the registration element170in the correlated image so as to register the object200with the coordinate system300.

The controller190is arranged to allow formation of a plan of a procedure on the object200in relation to the three-dimensional surface image thereof prior to the object200being correlated with the registration element170in the three-dimensional surface image thereof. If the optical scanner400is engaged with the robot tracking arm500, the controller190may be further arranged to track a position of the robot tracking arm500and the optical scanner400operably engaged with the distal end520thereof in relation to the coordinate system300. In either instance, once the object200is correlated with the registration element170, as determined with respect to the coordinate system300associated with the registration element170in the three-dimensional surface image from the optical surface scan, the plan of the procedure, which was determined and developed with respect to the three-dimensional surface scan, can be subsequently used to guide a robot800, such as a surgical robot, having a surgical instrument820engaged therewith (and operably engaged with the robot tracking arm500in communication with the registration element170affixed to the patient) to execute the plan of the procedure by the surgical instrument820on the object200in relation to the registration of the object200with the coordinate system300.

In one aspect of the present disclosure, a method of relating an object200to a coordinate system300involves an arrangement wherein the object200is supported by a support element220, and wherein the object200and the support element220are housed within a housing240. In one example, such an arrangement may include a tooth as the object, the corresponding jaw and/or gums as the support element, and the mouth or maxillofacial structure as the housing. The method may thus include engaging a registration element170with the object or the support element (FIG.7, block900). In some instances, the registration element170is disposed in or otherwise exists in a known relation in or with the coordinate system300, as disclosed herein. An optical surface scan of the object and the registration element, within the housing, is then conducted, using an optical scanner400(in some instances, the optical scanner400may be hand held and manually manipulated, or the optical scanner400may be operably engaged with a distal end520of a robot tracking arm500), to form a three-dimensional surface image of the object in relation to the registration element170(FIG.7, block920). The optical surface scan by the optical scanner400digitizes the image of the object and the registration element170, in the form of the three-dimensional surface image, and the three-dimensional surface image of the object is then correlated with the registration element, such that the object is then registered with the coordinate system (e.g., translate the image from an Image Coordinate Space (coordinate space internal to the image) to a Patient Coordinate Space (coordinate space in relation to the patient or the registration element170)) (FIG.7, block940).

Another aspect of the present disclosure is directed to a method of controlling a robot800with respect to an object200in a coordinate system300, wherein such a method involves an arrangement having the object200supported by a support element220, and with both the object200and the support element220being housed within a housing240. In one example, such an arrangement may include a tooth as the object, the corresponding jaw and/or gums as the support element, and the mouth or maxillofacial structure as the housing. The method may thus include engaging a registration element170with the object200or the support element220(FIG.8, block1000) and then conducting an optical surface scan of the object and the registration element, using an optical scanner400(in some instances, the optical scanner400may be hand held and manually manipulated, or the optical scanner400may be operably engaged with a distal end520of a robot tracking arm500), to form a three-dimensional surface image of the object, wherein the three-dimensional surface image has the coordinate system300associated therewith, and wherein the registration element170is associated with the coordinate system300(FIG.8, block1020). A plan of a procedure on the object is formed (FIG.8, block1040), for example, from the three-dimensional surface image, prior to correlating the object with the registration element in the three-dimensional surface image so as to register the object with the coordinate system (e.g., translate the image from an Image Coordinate Space (coordinate space internal to the image) to a Patient Coordinate Space (coordinate space in relation to the patient or the registration element170)) (FIG.8, block1060). A robot800having a surgical instrument820engaged therewith may then be guided to execute the plan of the procedure by the surgical instrument820on the object200in relation to the registration of the object200with the coordinate system300(FIG.8, block1080).

In some aspects, particularly in relation to the two method aspects disclosed hereinabove, a radiographic scan of the housing, and the object and support element housed therein, may be conducted to form a radiographic image of the housing, object, and support element, prior to the registration element being engaged with the object or the support element (FIG.7, block960,FIG.8, block1100). The radiographic image of the object is then image-matched with the three-dimensional surface image of the object so as to form a correlated image of the object in relation to the registration element (FIG.7, block970,FIG.8, block1120). The object is then correlated with the registration element in the correlated image so as to register the object with the coordinate system (e.g., translate the correlated image from an Image Coordinate Space (coordinate space internal to the correlated image) to a Patient Coordinate Space (coordinate space in relation to the patient or the registration element170)) (FIG.7, block980,FIG.8, block1140).

In some aspects, image-matching the radiographic image with the three-dimensional surface image may involve image-matching a three-dimensional structural representation of the object and the support element provided by the radiographic scan with the three-dimensional surface image of the object, the support element, and the registration element provided by the optical surface scan. In this manner, the plan for the procedure may then be formed based on and in consideration of both the aesthetic aspects of the procedure seen in the three-dimensional surface image of the optical surface scan (e.g., an intra-oral scan showing, for example, the gum and soft tissue about the tooth) as well as particular anatomic structures of interest seen in the three-dimensional structural representation of the radiographic scan (e.g., a computerized tomography (CT) scan showing, for example, the nerves, teeth roots, jawbones, and/or relate structure).

In some instances, since the registration element is associated with the optical surface scan, the registration element need not be radiopaque, but may be radiopaque if necessary or desired. In other instances, the registration element170may include, e.g., one or more fiducial markers, fiducial beads, etc., engaged with a reference frame (e.g., a splint), prior to the reference frame being engaged with the object or the support element. Engagement with the object (e.g., tooth) or the support element (e.g., gums or jaw) with the reference frame (e.g., splint) may be accomplished, for example, by way of a suitable adhesive (e.g., an epoxy) disposed therebetween. In other instances, for example, in the case of an edentulous patient, an implant anchor may be implanted in a jawbone and the reference frame (e.g., splint) may be securely attached thereto by a removable fastener.

In still other instances, the registration element may be arranged/configured to be in a known relation with the coordinate system. For example, the optical surface scanning device (e.g., the intra-oral scanning device, intra-oral scanner, or any other suitable light- or optical-based three-dimensional surface scanner/digitizer) may be operably engaged with the distal end of a robot tracking arm. The robot tracking arm, in turn, may be tracked by a controller in communication therewith, and the known or tracked position of the robot tracking arm may include the distal end thereof. Since the intra-oral scanner is engaged with the distal end of the robot tracking arm in such instances, the position of the imaging portion of the intra-oral scanner may also be known by the controller. The known position(s) of the robot tracking arm, as well as the intra-oral scanner engaged with the distal end of the robot tracking arm allows the controller to associate a coordinate system with the position(s) of the robot tracking arm and the intra-oral scanner. Further, the intra-oral scanner may be configured and arranged such that the digitized image of the registration element (and/or e.g., one or more fiducial markers engaged therewith) includes or is indicative of a ranging relationship (e.g., distance between the imager of the intra-oral scanner and a point on the imaged surface) between the intra-oral scanner and the imaged object. With such a ranging relationship, the relation of the registration element with the coordinate system is known to the controller upon being imaged by the intra-oral scanner engaged with the distal end of the robot tracking arm.

In other instances, the relation of the registration element with the coordinate system may be known or determinable in different manners in addition to or in the alternative to the relation between the intra-oral scanner and the registration element. For example, an emitter-detector arrangement may be provided in communication between the registration element and the intra-oral scanner and/or the robot tracking arm. In other instances, a transceiver-transceiver arrangement, a transceiver-reflector arrangement, a transmitter-receiver arrangement, or a sensor arrangement, as appropriate, may be implemented such that the registration element is in communication with and in a known position with respect to the intra-oral scanner/robot tracking arm, and therefore disposed in a known relation with respect to the coordinate system.

Once the optical surface scan is completed, the procedure on the object can then be planned in relation to the three-dimensional surface image of the object either before or after the object is correlated with the registration element in the three-dimensional surface image thereof. In some particular aspects, the procedure on the object is planned in relation to the three-dimensional surface image of the object prior to the object being correlated with the registration element in the three-dimensional surface image thereof so as to register the object and the planned procedure with the coordinate system. In instances of a robotic surgical procedure being planned, a robot (or a robot arm supporting a surgical tool for carrying out the surgical procedure) can then be guided by the controller to execute the plan of the procedure on the object using the surgical tool in relation to the registration of the object with the coordinate system. Such procedure planning and robot guidance based on the optical surface scan may be advantageous, for example, in instances where the planned procedure is on the object itself (e.g., a tooth), or otherwise involves a surface feature related to or associated with the object. In one instance, such a procedure may involve abrading the object (tooth) in preparation for receiving a crown.

In instances where a radiographic scan (e.g., a computerized tomography (CT) scan) is also conducted prior to the optical surface scan, the radiographic image may be correlated with the three-dimensional surface image, for example, using an image-matching procedure implemented by the controller or other suitable computer device in receipt of the data for both the radiographic scan and the optical surface scan. That is, in some aspects, a three-dimensional structural representation of the object and the support element provided by the radiographic scan may be image-matched (e.g., based on anatomical features common to both images) with the three-dimensional surface image of the object, the support element, and the registration element provided by the optical surface scan to form a correlated image. Once the correlated image is formed, the object can then be correlated with the registration element in the correlated image so as to register the object with the coordinate system. Depending on the nature of the procedure (e.g., whether the procedure is to be conducted on anatomical features/structure underlying the surface, on surface features, or both), the procedure on the object may be planned in relation to the three-dimensional surface image thereof from the optical surface scan, from the radiographic image thereof from the radiographic scan, or from the correlated image thereof including the three-dimensional surface image and the radiographic image. In this manner, the procedure on the object may also be planned prior to the object being correlated with the registration element in the correlated image thereof.

The disclosed methods and systems thus reduce or eliminate the need for a second radiographic scan (e.g., CT scan) as part of a pre-operative process for a robotic surgical procedure, and it may be advantageous to reduce the x-ray exposure of the patient by removing this second radiographic scan. By taking an optical three-dimensional surface scan of the feature of interest (e.g., an intra-oral scan) and including the fiducial marker array (e.g., mounted on the splint, with the splint engaged with the patient) in the intra-oral scan, the imaged fiducial marker array in the scan is used to register the optical three-dimensional surface scan with the patient and/or the locations of the features (e.g., anatomical features). Once the optical three-dimensional surface scan is registered with the coordinate system associated with the fiducial marker array engaged with the patient, the imaged features (e.g., the three-dimension surface image of the anatomy) from the intra-oral scan can be can be registered with the imaged features (e.g., the radiographic image of the structure of the anatomy) from the original/first CT scan. The plan for the procedure and other information associated therewith, developed from the original/first CT scan, can then be applied in reference to the patient and/or the locations of the anatomical features of the patient (e.g., within the coordinate system associated with the fiducial marker array) based on the relation to the coordinate system provided by the intra-oral scan.

In further aspects, the optical three-dimensional surface scan (e.g., intra-oral scan) may eliminate the need for both the first and second CT scans. For example, in some cases, the surgeon may not need a CT scan (e.g., radiographic imaging of anatomical features) to accomplish the intended procedure. This could be applicable to robotic procedures beyond, for instance, dental implants, and extend to, for instance, a tooth preparation procedure involving drilling or abrading away a tooth surface (e.g., to eliminate decayed areas of the tooth) and prepare the remaining portion of the tooth for receiving a crown (e.g., a prosthetic tooth) thereon. In such instances, the intra-oral scan alone may be sufficient for the purpose of planning the procedure, and the fiducial marker array included in the intra-oral scan can be used to register the intra-oral scan with the patient and/or the locations of the features of the patient (e.g., within the coordinate system associated with the fiducial marker array).

The implementation of the optical surface scan using, for example, an intra-oral scanner, allows the mouth (or teeth therein) and the fiducial marker to be scanned and imaged during surgery while the patient is unconscious, whereas the patient must often be awake and conscious during a CT scan with the fiducial marker(s) in place. The image from the intra-oral scan (with the fiducial marker(s) in place) can then be correlated with the image from the prior CT scan (without the fiducial marker(s) in place) by matching the anatomical geometry or features between the images. Since the imaging captured by the intra-oral scanner is already related to the fiducial marker(s) and thus integrated into and registered with the Patient Coordinate Space via interaction with the fiducial marker(s), the intra-oral scan/image (and the CT scan/image, if implemented), including the object and the fiducial marker(s), is thus readily relatable to the mechanical tracking (robot) arm in registration with the Patient Coordinate Space reference and thus can be readily integrated into the robotic system overall to guide the robot in the procedure.

Many modifications and other aspects of the disclosure set forth herein will come to mind to one skilled in the art to which this disclosure pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the disclosure is not to be limited to the specific aspects disclosed and that modifications and other aspects are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.

It should be understood that although the terms first, second, etc. may be used herein to describe various steps or calculations, these steps or calculations should not be limited by these terms. These terms are only used to distinguish one operation or calculation from another. For example, a first calculation may be termed a second calculation, and, similarly, a second step may be termed a first step, without departing from the scope of this disclosure. As used herein, the term “and/or” and the “/” symbol includes any and all combinations of one or more of the associated listed items.

As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises”, “comprising”, “includes”, and/or “including”, when used herein, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. Therefore, the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting.