阅读说明：本技术 一种个性化基台-冠一体式临时修复体及其制备方法和应用 (Personalized abutment-crown integrated temporary prosthesis and preparation method and application thereof ) 是由 胥春 庄嘉宝 吴雅琴 宋迎爽 瞿方 王莹莹 于 2020-07-02 设计创作，主要内容包括：本发明公开了一种个性化基台-冠一体式临时修复体,所述临时修复体包括牙冠和钛基底,且所述牙冠和所述钛基底粘接成一个整体；所述临时修复体穿龈轮廓与天然牙穿龈轮廓协调一致。本发明还公开了所述个性化基台-冠一体式临时修复体的制备方法及应用。本发明结合种植个性化美学修复和数字化修复的理念,利用数字化镜像技术设计制作出适合患者个体的、与天然牙穿龈轮廓协调一致的个性化基台-冠一体式临时修复体；在种植体植入3-6个月、达到稳定的骨结合后,将所述临时修复体安置于牙种植体上,用于美学区种植体周软组织塑形,以获得个性化的、美观的种植体周软组织形态,达到理想的牙种植修复美学效果。(The invention discloses a personalized abutment-crown integrated temporary prosthesis, which comprises a dental crown and a titanium substrate, wherein the dental crown and the titanium substrate are bonded into a whole; the temporary restoration body is coordinated with the natural tooth gum-penetrating contour. The invention also discloses a preparation method and application of the personalized abutment-crown integrated temporary restoration. The invention combines the planting concept of personalized aesthetic restoration and digital restoration, and utilizes the digital mirror image technology to design and manufacture a personalized abutment-crown integrated temporary restoration which is suitable for individual patients and is consistent with the natural tooth gum-penetrating outline; after the implant is implanted for 3-6 months and stable osseointegration is achieved, the temporary prosthesis is arranged on the dental implant and used for shaping the peripheral soft tissue of the implant in the aesthetic region, so that the personalized and beautiful peripheral soft tissue form of the implant is obtained, and the ideal aesthetic effect of dental implant restoration is achieved.)

1. The personalized abutment-crown integrated temporary prosthesis is characterized by comprising a dental crown and a titanium substrate, wherein the dental crown and the titanium substrate are bonded into a whole; the temporary restoration body is coordinated with the natural tooth gum-penetrating contour.

2. The one-piece abutment-crown temporary restoration according to claim 1, wherein in the temporary restoration, the free end of the titanium substrate is mated with a dental implant for fixing the temporary restoration to the dental implant.

3. The personalized abutment-crown integrated temporary restoration according to claim 1 or 2, wherein the material of the crown is machinable resin or ceramic.

4. A method for preparing a personalized abutment-crown integrated temporary prosthesis is characterized by comprising the following steps:

obtaining three-dimensional morphological data of the hard tissues of the oral craniomaxillofacial part;

reconstructing the tooth morphology of the missing tooth;

obtaining three-dimensional position information and a three-dimensional digital model of the missing tooth, the adjacent tooth and the implant;

and obtaining the shape of the abutment-crown integrated temporary prosthesis.

5. The method for manufacturing a personalized abutment-crown integrated temporary prosthesis according to claim 4, wherein in the manufacturing method, three-dimensional morphological data of oral craniomaxillofacial hard tissue is obtained by CBCT.

6. The method for manufacturing the personalized abutment-crown integrated temporary prosthesis according to claim 4, wherein in the manufacturing method, on the basis of the three-dimensional shape data of the hard tissue of the oral craniomaxillofacial part, the three-dimensional shape data of the contralateral homonymous tooth is extracted, and the tooth body shape of the missing tooth is reconstructed by using a mirror image method.

7. The method for preparing a personalized abutment-crown integrated temporary restoration according to claim 4, wherein in the preparation method, a three-dimensional digital model containing information of three-dimensional positions of gingiva and contralateral homonymous tooth in the edentulous area of a patient, a crown of an adjacent tooth and an implant is obtained by optical scanning.

8. The manufacturing method of the personalized abutment-crown integrated temporary restoration according to claim 6 or 7, wherein in the manufacturing method, the missing tooth form obtained by the mirror image method is placed in the missing tooth area, and the abutment-crown integrated temporary restoration form is obtained according to the three-dimensional position of the implant and the positional relationship with the adjacent tooth.

9. The method for manufacturing a personalized abutment-crown integrated temporary prosthesis according to claim 4, wherein a crown is obtained by cutting a resin or a ceramic material using a numerical control processing device according to the form of the abutment-crown integrated temporary prosthesis; and bonding the dental crown and the titanium substrate into a whole to prepare the personalized abutment-crown integrated temporary prosthesis.

10. The application of the personalized abutment-crown integrated temporary restoration in dental implantation aesthetic restoration according to any one of claims 1-9, wherein in the second stage of dental implantation treatment, the temporary restoration is placed on a dental implant by using the titanium substrate, and personalized shaping is performed on surrounding soft tissues of the dental implant so as to obtain personalized and attractive implant surrounding soft tissue morphology and achieve the ideal dental implantation aesthetic restoration effect.

Technical Field

The invention relates to the technical field of dental implantation aesthetic restoration, in particular to a personalized abutment-crown integrated temporary restoration and a preparation method and application thereof.

Background

Current dental implant restoration treatments for patients with aesthetic defects of dentition typically include three main steps: (1) implanting an implant in a first operation; (2) performing a second-stage operation after the implant is implanted for 3-6 months, exposing an implant sealing screw, replacing the implant sealing screw with a finished healing abutment or a manually-made implant support temporary crown, and performing implant peripheral soft tissue shaping; (3) and 3-4 months after the soft tissue is shaped, taking a mold to manufacture a permanent abutment and a crown restoration body, and fixing the permanent abutment and the crown restoration body on the upper implant to finish the dental implantation restoration treatment. The second stage of operation and the subsequent soft tissue shaping are one important intervention for the aesthetic effect of the implanted denture and are necessary steps for obtaining healthy and beautiful implant gum penetrating cuffs.

At present, the peri-implant soft tissue shaping generally adopts the following two methods: firstly, a finished product healing abutment is adopted for soft tissue shaping, but the implant formed after shaping has a single gum penetrating cuff shape, has larger difference between the shape and the size and the natural gum penetrating outline, is difficult to match the individual gum shape of a patient, cannot realize the optimal soft tissue aesthetic effect, and cannot wear a proper crown prosthesis in the tooth lacking area of the patient during shaping, thereby influencing the beauty and pronunciation; when a finished product healing base platform with the diameter of the gum penetrating part smaller than the diameter of the neck of the corresponding part of the natural tooth is selected, because the finished product healing base platform cannot well support soft tissues around the implant, the edge of the shaped soft tissues is positioned in the crown of the natural tooth gum, the axial length of the crown is insufficient after final restoration is finished, and the curve of the front dentition gum is not attractive. When the diameter of the gingiva penetrating part of the finished healing abutment is larger than the diameter of the neck of the natural tooth, soft tissues are excessively retracted after shaping, and the edge of the soft tissues is positioned at the root of the natural tooth and the gum, so that the axial length of the tooth crown is lengthened after final repair is finished, the gum curve is not coordinated, and the appearance is influenced. The shape of the finished healing abutment is greatly different from the shape of the neck of the natural tooth, and the finished healing abutment has single shape and lacks diversity: if the shape of the upper anterior tooth healing abutment of the finished product is cylindrical or truncated cone-shaped, the cross section is circular, the shape of the cross section is greatly different from that of the irregular circular triangle at the neck of the natural upper anterior tooth, and the ideal shaping effect of the peripheral soft tissue of the implant is difficult to achieve. And the finished healing abutment is mostly made of titanium and titanium alloy, the appearance is difficult to change, and the gingival penetrating form consistent with the natural tooth is difficult to obtain. The temporary crown is formed by manually stacking and molding resin on the temporary abutment, compared with a finished product healing abutment, the method can achieve a more ideal gum shaping effect, but a patient needs to see a doctor many times during shaping, the temporary crown is repeatedly detached from a patient implant many times, the gum penetrating outline of the temporary crown is adjusted and changed beside a chair, the number of times of patient seeing a doctor is increased, the repeated detachment of the temporary crown is easy to affect the healing of soft tissues at the gum penetrating cuff and cause pain and discomfort of the patient, and the monomer released by adding the resin when the temporary crown is adjusted and changed beside the chair and the surface of the temporary crown after adjustment and change are difficult to highly polish, so that local soft tissues can be stimulated, and the health of the patient can be affected. (Wittneben JG, Buser D, Belser UC, Bragg U.S. Peri-Implantation soft tissue conditioning with a compressive recovery in the destructive zone: the dynamic compression technique. int J Periodonics retrieval 2013,33(4)) furthermore, the shaping effect of the temporary crown made by manual stacking is completely dependent on the experience of the technician or clinician, the quality being difficult to control.

In recent years, digitization techniques have been used in implant denture repair treatments. The digital impression of dentition and oral cavity soft tissue of a patient and the three-dimensional position of an implant are obtained through an optical scanning technology, the three-dimensional image data of hard tissues such as teeth, jaw bones and the like of the patient are obtained through a Cone Beam CT (CBCT) technology, and an implant abutment and an upper part repairing structure (a crown, a bridge and the like) are designed and manufactured through a CAD/CAM technology by combining the data of the dentition and the oral cavity soft tissue of the patient and the three-dimensional image data of the hard tissues such as the teeth, the jaw bones and the like. The development of these digital techniques provides the possibility to make an implant support temporary restoration with a personalized, transgingival contour more closely resembling the transgingival morphology of natural teeth. It has been reported that a digital technique is used to make a personalized healing abutment for peri-implant soft tissue shaping (Jodat, Ferrari M, Braegger U.A digital approach for one-step formation of the superior-implantation procedure with an induced CAD/CAM healing. J-procedure Res.2016; 60(3): 220) 223). The mode can acquire individualized gum-penetrating outline to a certain extent, but because it lacks the dental crown, influence the patient beautifully during moulding, pronounce, especially do not have the adjacent relation with adjacent tooth, can't form the extrusion effect to gum abduction clearance department soft tissue with adjacent tooth during moulding, be difficult to rebuild the gum nipple that lacks the tooth area and miss, easily lead to the front gum abduction clearance department to leave "black triangle" after the restoration, can't obtain the most ideal soft tissue aesthetic effect.

Therefore, it is highly desirable to provide a personalized abutment-crown integrated temporary prosthesis suitable for individual patients and consistent with the natural gum-penetrating contour of the teeth, so as to solve the above problems and obtain more natural and plump aesthetic effect of soft tissues around the implant.

Disclosure of Invention

The invention aims to provide a personalized abutment-crown integrated temporary prosthesis which is used for shaping peri-implant soft tissue in an aesthetic region, so as to obtain personalized and beautiful peri-implant soft tissue morphology and achieve ideal dental implantation restoration effect in the aesthetic region.

In order to achieve the purpose, the invention adopts the following technical scheme.

The invention provides a personalized abutment-crown integrated temporary prosthesis, which comprises a dental crown and a titanium substrate, wherein the dental crown and the titanium substrate are connected into a whole through an adhesive; the temporary restoration body is coordinated with the natural tooth gum-penetrating contour.

In some embodiments, the free end of the titanium substrate is mated with a dental implant in the temporary prosthesis to secure the temporary prosthesis to the dental implant. When the temporary prosthesis is arranged on the dental implant during the second stage of the implantation treatment, the personalized shaping can be carried out on the soft tissues around the implant.

In some embodiments, the material of the crown of the temporary restoration is a machinable resin or ceramic.

The invention also provides a preparation method of the personalized abutment-crown integrated temporary restoration, which comprises the following steps:

obtaining three-dimensional morphological data of the hard tissues of the oral craniomaxillofacial part;

reconstructing the tooth morphology of the missing tooth;

obtaining three-dimensional position information and a three-dimensional digital model of the missing tooth, the adjacent tooth and the implant;

and obtaining the form of the personalized abutment-crown integrated temporary restoration.

In some embodiments, in the preparation method, three-dimensional morphological data of the oral craniomaxillofacial hard tissue is obtained by CBCT (cone beam CT); may be saved as a DICOM format file.

In some embodiments, in the preparation method, on the basis of the three-dimensional morphological data of the hard tissues of the oral craniomaxillofacial part, the three-dimensional morphological data of the contralateral homonymous teeth is extracted, and the tooth body morphology of the missing teeth is reconstructed by using a mirror image method; may be saved as an STL format file.

In some embodiments, in the preparation method, a three-dimensional digital model containing three-dimensional morphology of gingiva and contralateral homonymous tooth in the edentulous region of the patient, a crown of an adjacent tooth and three-dimensional position information of the implant is obtained through optical scanning; may be saved as an STL format file.

In some embodiments, in the preparation method, the missing tooth form obtained by the mirror image method is placed in the missing tooth area, and the personalized abutment-crown integrated temporary restoration form is obtained according to the three-dimensional position of the implant and the position relation with the adjacent tooth.

In some embodiments, according to the form of the personalized abutment-crown integrated temporary restoration, a resin or ceramic material is cut by a numerical control processing device to obtain a crown, and the crown and a titanium substrate are connected into a whole through an adhesive to prepare the personalized abutment-crown integrated temporary restoration.

In the present invention, the specific operations of the steps in the preparation method can be realized by adopting the conventional operations in the field.

The invention also provides the application of the personalized abutment-crown integrated temporary restoration in the aesthetic restoration of dental implantation, and during the second-stage operation of implantation treatment, the temporary restoration is arranged on the dental implant by utilizing the titanium substrate, and the personalized shaping is carried out on the peripheral soft tissue of the dental implant, so that the personalized and beautiful form of the peripheral soft tissue of the implant can be obtained, and the ideal aesthetic restoration effect of dental implantation is achieved.

In the invention, according to the implantation personalized aesthetic restoration concept, a DICOM format file of the same-name tooth form of the contralateral side of a single upper anterior tooth missing patient is obtained through CBCT, is placed in a tooth missing area after digital mirror image, reconstructs the tooth form of the missing tooth, and fitting with STL format files of gingiva in edentulous area, same-name teeth on opposite side, adjacent tooth crown shape and three-dimensional position of implant obtained by optical scanning to obtain a three-dimensional digital model containing soft and hard tissues in edentulous area and adjacent area of patient and three-dimensional position information of implant, designing and manufacturing a personalized abutment-crown integrated temporary prosthesis which is suitable for individual patient and is consistent with natural tooth penetrating gingival contour by CAD/CAM technology, and placing the temporary prosthesis on dental implant for soft tissue shaping around implant during second-stage implant treatment (after implant implantation for 3-6 months and stable osseointegration). During the shaping, the temporary crown can well restore the form and the pronunciation function of the missing tooth of the patient, and the adjacent relation with the adjacent tooth is restored, so that the gingival papilla missing in the missing tooth area can be shaped and reconstructed through the extrusion effect on the soft tissue at the gingival abduction gap, and the more natural and plump aesthetic effect of the soft tissue around the implant can be obtained. The method has important significance and clinical value for obtaining more ideal and more personalized implant peripheral soft tissue shaping and improving the repair treatment effect of the implant denture in the aesthetic region.

The invention has the beneficial effects that:

the abutment-crown integrated temporary prosthesis has the advantages that the gingival penetrating outline is coordinated with the natural tooth gingival penetrating outline and is arranged on the dental implant, and the individualized and attractive soft tissue shape around the implant can be obtained. The invention adopts the shape of the soft tissue around the implant after the personalized abutment-crown integrated temporary restoration is shaped to form the soft tissue outline which is harmonious and consistent with the natural gum, and has good application effect in the shaping of the soft tissue around the implant.

The preparation method of the invention combines the planting concept of personalized aesthetic restoration and digital restoration, utilizes the digital technology to design and manufacture the dental crown which is suitable for the individual of the patient and is consistent with the natural tooth gum-penetrating outline, and is adhered with the titanium substrate into a whole to obtain the temporary restoration. The dental crown obtained in the invention replaces the healing abutment in the conventional method to a certain extent, and the temporary restoration of the invention is coordinated with the natural tooth gum-penetrating outline, the structure of the temporary restoration is obviously superior to that of the conventional healing abutment, and the temporary restoration is arranged on an implant, so that the shaping of the peripheral soft tissue of the dental implant can be realized, the personalized and beautiful peripheral soft tissue form of the implant can be obtained, and the ideal aesthetic restoration effect of the dental implant can be achieved.

Drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.

Fig. 1 is a first structural schematic view of the personalized abutment-crown integrated temporary prosthesis of the present invention.

Fig. 2 is a schematic structural diagram of the personalized abutment-crown integrated temporary prosthesis of the present invention.

FIG. 3 is a schematic diagram of the three-dimensional morphology of the hard tissue of the oral craniomaxillary face obtained in the preparation method of the present invention.

Fig. 4 is a schematic representation of the morphology of a missing tooth reconstructed in the preparation method of the present invention.

Fig. 5 is a schematic diagram of a three-dimensional digital model of a missing tooth, an adjacent tooth and an implant obtained in the preparation method of the present invention.

Detailed Description

The technical solution in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention. It is to be understood that the described embodiments are merely exemplary of the invention, and not restrictive of the full scope of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It is to be understood that the objects so described are interchangeable under appropriate circumstances. Furthermore, the terms "comprising" and "having," as well as any variations thereof, are intended to cover non-exclusive inclusions. In this patent document, the drawings discussed below and the embodiments used to describe the principles of the present disclosure are by way of illustration only and should not be construed in any way to limit the scope of the present disclosure. Those skilled in the art will understand that the principles of the present invention may be implemented in any suitably arranged system. Reference will now be made in detail to the exemplary embodiments, examples of which are illustrated in the accompanying drawings. The terms used in the description of the present invention are only used to describe specific embodiments, and are not intended to show the concept of the present invention. In the present specification, it is to be understood that terms such as "comprising," "having," and "containing" are intended to specify the presence of stated features, integers, steps, acts, or combinations thereof, as taught in the present specification, and are not intended to preclude the presence or addition of one or more other features, integers, steps, acts, or combinations thereof.

The embodiment of the application provides a personalized abutment-crown integrated temporary prosthesis, which comprises a dental crown and a titanium substrate, wherein the dental crown and the titanium substrate are connected into a whole through an adhesive; the temporary restoration body is coordinated with the natural tooth gum-penetrating contour.

In some embodiments, the free end of the titanium substrate is mated with a dental implant in the temporary prosthesis to secure the temporary prosthesis to the dental implant.

In some embodiments, the material of the dental crown is a machinable resin or a ceramic.

The embodiment of the application also provides a preparation method of the personalized abutment-crown integrated temporary prosthesis, which comprises the following steps:

obtaining three-dimensional morphological data of the hard tissues of the oral craniomaxillofacial part;

reconstructing the tooth morphology of the missing tooth;

obtaining three-dimensional position information and a three-dimensional digital model of the missing tooth, the adjacent tooth and the implant;

and obtaining the form of the personalized abutment-crown integrated temporary restoration.

In some embodiments, in the preparation method, three-dimensional morphological data of the oral craniomaxillofacial hard tissue is obtained by CBCT (cone beam CT); for example as a DICOM format file.

In some embodiments, in the preparation method, on the basis of the three-dimensional morphological data of the hard tissues of the oral craniomaxillofacial part, the three-dimensional morphological data of the contralateral homonymous teeth is extracted, and the tooth body morphology of the missing teeth is reconstructed by using a mirror image method; for example, as an STL format file.

In some embodiments, in the preparation method, a three-dimensional digital model containing three-dimensional morphology of gingiva and contralateral homonymous tooth in the edentulous region of the patient, a crown of an adjacent tooth and three-dimensional position information of the implant is obtained through optical scanning; for example, as an STL format file.

In some embodiments, in the preparation method, the missing tooth form obtained by the mirror image method is placed in the missing tooth area, and the personalized abutment-crown integrated temporary restoration form is obtained according to the three-dimensional position of the implant and the position relation with the adjacent tooth.

In some embodiments, according to the form of the personalized abutment-crown integrated temporary restoration, a resin or ceramic material is cut by a numerical control processing device to obtain a crown, and the crown and a titanium substrate are connected into a whole through an adhesive to prepare the personalized abutment-crown integrated temporary restoration.

The embodiment of the application also provides application of the personalized abutment-crown integrated temporary restoration in dental implantation aesthetic restoration, and during a second-stage implant treatment operation, the temporary restoration is placed on a dental implant, and personalized shaping is performed on peripheral soft tissues of the dental implant, so that personalized and attractive implant peripheral soft tissue shapes are obtained, and an ideal dental implantation aesthetic restoration effect is achieved.

The embodiment provides a specific application of the personalized abutment-crown integrated temporary prosthesis in aesthetic dental implant repair, which is as follows:

before shaping, the soft tissue shape of the maxillary anterior tooth area, the soft tissue edge position around the implant, the shape of the implant gum-penetrating cuff are different from those of the natural tooth and are not harmonious.

The temporary restoration is arranged on the dental implant through a titanium screw matched with the titanium substrate, and the application time of the personalized abutment-crown integrated temporary restoration is the time of the second-stage implant operation after the implant is implanted for 3-6 months and stable osseointegration is achieved.

Because the gum penetrating outline of the temporary restoration is obtained by mirroring the same-name natural tooth on the opposite side, the gum penetrating outline is more consistent with the gum penetrating outline of the natural tooth, the individualized shaping can be carried out on the soft tissue around the dental implant, the soft tissue around the dental implant is completely healed at the moment, and the gum recession is not easy to occur during the shaping, so that the soft tissue around the dental implant which is more close to the natural gum form (including the gum margin level, the near-middle gum papilla and the far-middle gum papilla) can be obtained, and the more ideal aesthetic effect of dental implantation restoration is achieved.

In the personalized abutment-crown integrated temporary restoration, the form of the same-name tooth on the opposite side of the missing tooth is copied by extracting CBCT data and mirrored to the missing tooth area to obtain the form of the temporary restoration (including the gum penetrating outline), and the integrated temporary restoration is obtained by cutting resin or ceramic material through computer numerical control and adhering the resin or ceramic material with a titanium substrate, so that the soft tissue around the dental implant can be molded conveniently, and the form of the gingiva more approximate to the natural tooth can be obtained.

The abutment-crown integrated temporary prosthesis solves the problems that in the peripheral soft tissue shaping process of the implant in the oral cavity American area, the difference between the gingival penetrating outline and the size of a finished healing abutment is larger than that of a natural tooth, the appearance is difficult to adjust and change, the soft tissue shaping effect is poor, and the tooth lack area lacks a crown in the shaping period, so that the appearance and the pronunciation of a patient are influenced; the temporary crown made of the manual stack-molding resin needs a patient to see a doctor for many times, and the temporary crown is repeatedly disassembled and assembled during the soft tissue molding period to influence the healing of the gum-penetrating cuff and the health of the soft tissue.

In conclusion, the invention obtains the individual abutment-crown integrated temporary prosthesis which is suitable for the individual patient and is consistent with the natural tooth gum-penetrating outline, and the prosthesis can be well applied to the dental implantation restoration treatment in the American area to shape the soft tissue around the implant.

The soft tissue contour which is harmonious and consistent with the natural gingival margin is formed by adopting the peri-implant soft tissue form which is formed by the personalized abutment-crown integrated temporary restoration.

The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.