Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
2001-04-13
2003-10-28
Huson, Gregory L. (Department: 3751)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
C600S426000, C600S414000, C433S215000
Reexamination Certificate
active
06640128
ABSTRACT:
The present invention relates to a method and a device for navigation-assisted dental treatment, in accordance with patent claim
1
as well as the preamble of patent claim
13
. It further relates to the application of a device in accordance with the present invention for assisting in a dental treatment.
Dental treatments, in particular invasive dental treatments, are conventionally still mostly carried out to date without the aid of imaging or navigation. When carrying out invasive measures, the dentist mostly relies on what he can see in the patient's mouth and on his own experience. To aid him, especially in the case of orthodontics, x-rays are frequently brought into play.
This approach has a number of basic disadvantages. Inexperienced dentists could, for example when drilling into the jaw to insert an implant adaptor, drill or fraise in an incorrect direction or too far into the jaw, which in the worst case could lead to nerve damage. The x-ray images used are often distorted and thus introduce inaccuracies. The information from the x-ray image is only employed by the physician to note the anatomy, and this too can be a source of errors. The use of drilling templates is expensive and slows treatment.
A method for simplifying a dental diagnosis and treatment is known from U.S. Pat. No. 5,562,448, wherein the surface of a tooth and/or jaw structure is scanned with an instrument, whilst the movement of a second element arranged parallel thereto and performing the same movement, a so-called pantograph arm, is tracked with cameras. For the purposes of diagnosis, the surface of a tooth is covered and captured as data. To further assist, other information from x-ray images is additionally processed and integrated. Multiple and various pantograph units may be employed, and it is foreseen that the device in accordance with U.S. Pat. No. 5,562,448 be used to assist in treatment, and in particular for practice operations.
The fundamental disadvantage of the system described above is that only surface data are available to assist in treatment. The areas to be treated, however, are often in the interior of the tooth and/or jaw bone, respectively. With the method proposed here, it is possible to obtain precise data on such internal structures. This becomes especially evident when an orthodontic treatment is to be carried out in an area where a tooth is missing. The surface of the jaw bone itself may yet indeed be determined as necessary by invasive treatments, but its internal structure and position cannot be ascertained by means of this system. Moreover, preparing a treatment device or scanning device with a parallel pantograph arm attached at a distance by means of an attachment is costly, and a bulky instrument emerges which still has to be fixed to a pivoting arm to be manageable and operative.
It is the object of the present invention to provide a method and a device for navigation-assisted dental treatment which overcomes the aforesaid problems of the prior art. In particular, a sufficiently manageable navigation-assisted dental treatment system is to be proposed, which allows optimally precise treatments and surgery. This object is solved in accordance with the present invention by a method for assisting a dental treatment, wherein:
a three-dimensional volume data set for the tooth and/or jaw area of a patient is produced by means of an imaging method, for example tomographic imaging;
the tooth and/or jaw area is registered and/or referenced by means of a computer-assisted navigation and/or tracking system using the volume data set;
instruments and apparatus for treatment are registered and/or referenced relative to the computer-assisted navigation and/or tracking system, and positionally tracked; and wherein:
the navigation and/or tracking system supplies information for assisting and/or guiding the treatment before, during or after the treatment, by means of an output unit.
The advantage of this invention is based in particular on the provision of a three-dimensional volume data set for the tooth and/or jaw area of a patient. With such information, which may be obtained for example using a tomographic method, the physician carrying out the treatment now no longer has only surface information at his disposal, but also information on the internal structure of tooth and/or jaw, and may carry out the operation on the basis of this information. In this way, it can be ensured that healthy tissue or bone structures can be left largely untouched, while diseased or mutated structures can be completely removed. In the field of dental implantology in particular, the present invention enables drilling or fraising in the wrong direction to be ruled out and, because navigation and/or tracking are always providing information about the position of the drill or fraise tip, it is also possible to actively prevent drilling or fraising either too far or not far enough, such that nerve damage or a poor grip by a tooth implant adaptor can be avoided. In accordance with the present invention, the position of the relevant parts of the patient as well as the position of the instruments is known to the navigation and/or tracking system at all times, and all these data can be outputted to a screen and assist the physician with the treatment. The treatment thus becomes on the whole more precise; when inserting dental implant adaptors, this can extend to setting the dental prosthesis itself directly into a pre-determined position on the adaptor, without the need for ball joints, as hitherto used, for adjustment.
The device in accordance with the present invention comprises a device which produces a three-dimensional volume set for the tooth and/or jaw area of a patient by means of an imaging method, for example tomographic imaging, and registers and/or references the tooth and/or jaw area by means of the navigation and/or tracking system using the volume data set.
Within the framework of the present invention, the position of the instruments or apparatus for treatment is basically tracked by the navigation and/or tracking system. This can be sufficient if the head of the patient is held in place sufficiently and the position of the holding device in relation to the navigation and/or tracking system has been established. This applies in particular to treatment in the upper jaw area. Essentially, however, there also exists the possibility of positionally tracking the tooth and/or jaw area using the navigation and/or tracking system, in order to always have current data on the position of the area to be treated available. Such positional tracking of the tooth and/or jaw area is particularly recommendable where the patients are not held in place, or in treatment of the lower jaw.
In a preferred embodiment of the invention, the tooth and/or jaw, as well as the desired positional course of an instrument, planned to begin with or inter-operatively, are displayed on a screen output during treatment, and the actual positional course of the instrument is positionally tracked. When the desired positional course and the actual positional course deviate, a visual and/or acoustic warning signal can be given, so that the physician can make the appropriate corrections. In order to also be able to assist such corrections when deviations between the desired positional course and the actual positional course have been established, a new desired positional course can be calculated and outputted by the computer-controlled navigation and/or tracking system, which the physician can then follow.
Within the framework of the present invention, a navigation and/or tracking system may be used, wherein a data set comprising three-dimensional data of the tooth and jaw area is registered and/or referenced by means of one of the following methods:
referencing and/or registering the data set by means of anatomical landmarks;
referencing and/or registering the data set by means of artificial landmarks, in particular actively emitting or reflecting markers;
referencing and/or registering the data set by means of a surface-matching
Birkenbach Rainer
Vilsmeier Stefan
BrainLAB AG
Flynn Amanda
Huson Gregory L.
Renner , Otto, Boisselle & Sklar, LLP
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