DE102015208882A1 - Process for the production of dentures - Google Patents

Abstract

Provided is i.a. a method for the integrated production of dental prostheses for a person consisting of: A) transferring a digital volume tomogram of the person's face, including the person's lower jaw and upper jaw, to a computer unit; B) transmitting a digital pantographic record of the subject's joint path to the computer unit , C) creating a digital articulator from steps A) and B) in the computer unit, D) transferring the digital data of the articulator to a production unit, and E) producing the denture by means of the production unit.

Description

The invention relates to a method for the production of dental prostheses, for example a veneer. The method may include inserting the denture, such as a veneer, into a denture of a person.

A known method for producing and inserting a veneer into a denture of a person is as follows: First, the upper jaw and the lower jaw, in particular the teeth, are shaped by means of an impression. Thereafter, models of the upper jaw and lower jaw made of gypsum from a dental technician, who usually sits not in the dental office, made. In a further step, the lower jaw movement is determined in the dental practice, for example by means of an arbitrary face bow. The models are inserted by the dental technician in an articulator, whereby their connection is made so that the determined lower jaw movement can take place and the bite registration is correct. At the point in question of the dentition of the person to whom a veneer is to be attached, a model of the veneer is waxed in the model in the articulator. The wax model of the veneer is then scanned, for example, and the data obtained is used to produce the insertable veneer with the exact same dimensions as the wax model from a blank. After the dental technician has made the veneer, this must be brought back to the dental office - for example, by courier. There, the person is summoned to a new appointment, in which this person the veneer is glued to the intended location of the dentition. Since elaborate plaster models must be created by a dental technician, who is usually not sitting in the dental office, and transport time is added, this procedure takes a long time and the person must be summoned to the dental practice for at least two appointments.

In contrast, the invention proposes the method according to claim 1. Furthermore, the methods according to claims 2 and 6 are proposed. The invention also provides a system suitable for carrying out the methods of the invention.

The invention is explained in more detail below purely by way of example, without limitation of generality, with reference to specific dental prostheses, namely a veneer, and a special method of production, namely milling. The invention is analogous to the production of other types of dentures and use of all applicable in the art applicable manufacturing methods applicable.

A method according to the invention for producing and, if necessary, inserting a veneer into a denture of a person according to a first aspect, leads to the result of an inserted veneer more quickly in the dentition of the person.

Reference is made to claim 2. The fact that all steps of obtaining the data required for the milling data sets done digitally - ie the creation of the volume tomogram of the midface and the lower face and the pantographic recording of the joint track - it is possible to create without an analog model by a dental technician who Immediately make veneer in the dental office when the milling machine is in the dental office. The time delay incurred so far by interposing the model creation by the dental technician thus eliminated and the veneer can be glued directly to the person in an appointment with a short wait. The person does not have to come to the dentist for a second time, which saves both the dentist and the person time. In addition, the inventive method can be performed not only faster, but also cheaper than the previous method. An inventive method step is the use of the first data set and the second data set for creating a digital articulator by means of a computer program, wherein the data of the first data set by means of the performed imaging process by means of the digital volume tomogram with the measured individual temporomandibular joint data in the correct relation , this is realized by the application of person-specific, anatomical conditions. It can be explained more concretely, solely by means of the digital volume tomogram by rotation In the sagittal section plane, the vertices of the Bonwill triangle and the condylar path inclination are simply displayed and measured. By tilting the horizontal plane on the two condyles and the lower incision, the Bonwill triangle is shown from an axial viewpoint, whereby the actual basis, the individual Interkondylardistanz of the patient becomes readable. Only the Benett angle can not be obtained by the digital volume tomogram; this is recorded in the second record, which was obtained by means of the pantography.

An advantageous development of the invention provides that bringing into the correct relation of the first data set and the second data set by the definition of the Frankfurt horizontal or other anatomical crankshaft personal dimension of the patient on the basis of the first data set in relation to the recorded data of the lower jaw movement of the second record is done. Only the DVT can simply represent and measure the corner points of the Bonwill triangle and the condylar path inclination by rotating the sagittal section plane. By tilting the horizontal plane on the two condyles and the lower incision, the Bonwill triangle is shown from an axial viewpoint, whereby the actual basis, the individual Interkondylardistanz of the patient becomes readable. Only the Benett angle can not be raised by the digital volume tomogram, this is recorded in the second record, the pantography. This makes it impossible to arbitrarily approximate the complete jaw-related transmission with facebow but to transfer exactly the hinge axis of the two individual temporomandibular joints of the patient into the virtual articulator of the design software.

A further advantageous development of the invention provides that, as a further step before the creation of the digital articulator, an intraoral scan of the maxillary teeth and the mandibular teeth of the person takes place by means of an intraoral scanning camera and transmission of the third data set obtained thereby to the computer unit. As a result, it is possible to record the tooth stumps prepared, for example, considerably more accurately - in this case with 19/1000 mm -, to save the patient the most unpleasant impression taking and to completely dispense with the elaborate preparation of the working models with plaster.

A further advantageous development of the invention provides that, as a further step before the creation of the digital articulator, a digital acquisition of the face by static records and the dynamic movements by means of a face scanner and transmission of the fourth data set obtained thereby to the computer unit. The detection of the face by the face scan takes place both statically and dynamically. Thus, one can consider the aesthetic conditions for example in the length design of the anterior teeth when introducing soft tissue ratios, smile lines, lip dynamics, etc. in the middle and lower face individually.

A further advantageous embodiment of the invention provides that an insertion of the veneer takes place at the person by sticking at the predetermined location on the dentition of the person. This step can be done immediately after milling the veneer on site, so that no further appointment with the dentist is necessary.

A further advantageous embodiment of the invention provides that between the steps of the milling of the veneer and the insertion of the veneer, the veneer is fired in a zirconia. As a result, special zirconium restorations can also be carried out.

A further advantageous development of the invention provides that the three-dimensional bone and tooth ratios of the person are determined during the creation of the digital volume tomogram. This can be done together with the pantograph data more accurate determination of the required shape of the veneer, as if, for example, only the tooth conditions by an impression by means of impression material - as is done in the prior art - are determined.

A further advantageous development of the invention provides that the first data record is a DICOM data record and / or the third data record is an STL or XML data record and / or the second data record is an STL data record and / or the fourth data record is an OBJ data record is. As a result, standard devices can be used to create the records and the resulting records can be used within a standard software for a digital articulator.

A further advantageous development of the invention provides that in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt triangle, individual anterior guidance. Based on these measurements, a reliable creation of the digital articulator is possible.

A further advantageous embodiment of the invention provides that in the digital detection of the face, the static recordings include a face photograph and / or a profile photo and / or a smile photo and / or wherein in the digital detection of the face, the dynamic movements recording a mimic action and / or an opening of the mouth and / or a laughing process. Based on these values, an ideal setting of the virtual model in the digital articulator is possible.

A further advantageous embodiment of the invention provides that the digital articulator contains the data for the individual values of the person and its anatomical hinge axis. This allows the veneer to be adapted even better to the circumstances of the person, since not only the static values - such as teeth clenched - flow into, but also the dynamic values during chewing.

A further advantageous development of the invention provides that a five-axis milling machine is used as the milling machine. Such milling machines are reliable and can easily make all possible shapes of the veneer.

A further advantageous embodiment of the invention provides that all data of the person are transferred to a tablet computer and there the teeth and the veneer are displayed in selectable states. With this, the person can still be visualized on the dental chair, as the denture with the glued veneer will look like.

Further advantages and details of the invention will be explained with reference to an embodiment.

A digital volume tomogram of the middle and lower face is created by the person to whom a veneer is to be adhered to the dentition; The three-dimensional bone and tooth conditions of the person are recorded. For this creation, for example, the device ORTHOPANTOMOGRAPH OP300 of the manufacturer KaVo Dental GmbH is used. The first record thus obtained is in a DICOM format. DICOM stands for Digital Imaging and Communications in Medicine and is a standard format for medical data. The first data record is transmitted by means of known transmission methods - for example wirelessly via WLAN or Bluetooth or wired via a USB interface - to a computer unit and stored there and can be used by means of a - for example - Dicom viewer in the design software.

There is also a digital measurement of the joint track by pantographic recording. For this purpose, for example, the jaw registration system JMA system of the manufacturer zebris Medical GmbH is used. All information is obtained - such as the maxillary HCI angle, the horizontal condylar path inclination, the Bennett angle, the Posselt triangle and the individual anterior guidance - in order to be able to determine the setting values for a digital articulator. This happens in a given measurement sequence - such as by lower jaw movements such as protrusion and laterotrusion. In this case, a second data record is obtained in an STL format. Also, the second record is - as the first record - transmitted by known transmission paths to the computer unit and stored there.

In addition, the oral situation can be determined by means of an intraoral scan of the maxillary and mandibular teeth. This is done by means of a suitable scan camera, for example the CEREC Omnicam from the manufacturer Sirona Dental GmbH. A third record in STL or XML format is obtained. STL stands for STereoLithography. Also, the third record is - like the other two records - transmitted by known transmission paths to the computer unit and stored there. As a result, an even more accurate representation of the preparation margins of the tooth stumps, the interdental contacts, etc. is possible.

Furthermore, a digital acquisition of the face can be performed. This provides that by means of the face scanner both the static states - for example by a face photograph, a frontal photo or a smile photo - and the dynamic states - for example, the facial expressions, an opening process of the mouth or a laughing process - recorded and recorded. This is done by means of a known from the prior art face scanner, such as the model FACE HUNTER ZIRKONZAHN GmbH. On the basis of the values obtained, an individual adjustment of the virtual model into the digital articulator is possible. A fourth record in an OBJ format is obtained. OBJ stands for "object" and is a file format for the description of geometric objects. Also, the fourth record is - like the other three records - transmitted via known transmission paths to the computer unit and stored there. Thus, an even more accurate and, inter alia, more aesthetic individual design (for example, the length of the anterior teeth) of the dentures is possible.

The order of the aforementioned two compellingly necessary for the realization of the invention steps of the preparation of the volume tomogram and the pantographic recording of the joint track and the two other for the realization of the invention only optionally possible steps of creating the intraoral scan and the creation of the facial scan can in any order respectively. They are performed regularly one after the other as long as the person is in the dental office.

According to the invention, the measured individual temporomandibular joint data of the same person must be placed in the correct relation to the virtual person who is obtained from the above-described data sets after the imaging measures (digital volume tomogram). This can be realized by the application of person-specific, anatomical conditions. Thus, for example, the Frankfurt horizontal and the individual Interkondylarachse can be clearly defined as the actual reference basis based on the recording of the digital volume tomogram and the recorded data of lower jaw movements of the second record of pantographischen record the aforementioned data of the digital volume tomogram in relation to be brought by the record of the first record (Dicom record) as well as the second record (STL or XML data set) of the pantography - the trajectory record; Here: zebris JMA Kiefergelenk- and Unterkiefervermesser - in the interface of a dedicated design software - here: exocad DentalCAD, the company exocad GmbH - brings and this with a so-called "matching" - this is the superposition or the juxtaposition of records for Fine-tuning or matching - correlated and thus coordinated. This allows the lower jaw to be virtually separated from the skull. Because the lower jaw movements are unambiguous through the pantograph record (second record), the virtual mandible can be moved by the second record (zebris record) exactly as on the living person.

As a result, it is no longer necessary to have a physically existing articulator created by a dental technician. Thus, the cost of materials is reduced and - more importantly - the time required to create the articulator considerably shortened.

In contrast to the previous procedure in a physical articulator, in which a wax model of the veneer is waxed at the point at which the veneer is to be glued to the denture later, which then leads to the ceramic veneer by means of complicated procedures, can in the inventive Method, the shape of the veneer directly on the screen, for example by means of the above-mentioned design software exocad DentalCAD, set and the resulting fifth dataset are used for the production of the ceramic veneer. This fifth data set is transferred by means of known transmission methods - wirelessly or by cable - to a five-axis milling machine, for example the model inLab MC X5 from the manufacturer Sirona Dental GmbH. The milling and grinding process, as known from the prior art, by machining a selected blank - for example, a ceramic zirconia. In this case, the data of the fifth data record is used.

This saves an enormous amount of time compared to the method of the prior art, since, inter alia, no dental technician outside the dental practice must be consulted. The preparation of the ceramic veneer can begin immediately after the shape of the veneer has been determined.

After a short time, the veneer is ready and can be immediately glued into the dentition of the person.

Since all devices required for carrying out the method according to the invention can be used or set up easily in the dental practice with practice-own laboratories, everything can be carried out in a continuous workflow - ie everything bundled under one roof - and the person does not yet have to paste the veneer Once at a later date - after the dental technician has made the veneer and sent it to the dental office - come to the dental office.

Another advantage of the method according to the invention is that the person can be shown on the screen before creating the veneer, as the veneer looks in the dented state in the dentition. All that is required is to transfer all data of the person obtained from the first, second, and optionally third and fourth records, and in addition to transfer the fifth record representing the veneer to a tablet computer. There, the dentition and the veneer can then be displayed in selectable states. The person can then stop this production even before the transmission of the fifth data set to the milling machine and the beginning of the production of the veneer, if he does not like the virtual result displayed on the tablet computer. A new fifth record can then be created that results in a different shape of the veneer. This result can then be shown to the person again on the tablet computer. This process can be repeated until the person is satisfied with the result presented - there is then no "rude awakening" when the veneer is glued in and the overall impression of the dentition does not match the person's imagination.

In the method according to the invention, CAI (Computer Aided Imaging) - in the creation of the first and second, and optionally third and fourth data record - CAD (Computer Aided Design) - in the creation of the fifth data set - and CAM (Computer Aided Manufacturing) - when milling the veneer - together. The required equipment including computer programs and memory for the data obtained can all be easily kept in stock in the dental office, so that no additional time is incurred by the involvement of a foreign dental technician laboratory. Thus, the person only has to go to the dentist once more and, immediately after taking his data and creating the data for the veneer, he glues the veneer made in the dental practice.

In summary, it can be said that by means of the method according to the invention an absolutely true person-specific articulator is obtained, which is more purely personal, more genuine virtual, model-free articulator can be called. This means that the digital - or virtual - articulator is created without already having an arbitrary, the personal person-hinge axis only approximated face bow. No articulated, scanned-in models are needed and there are STL or XML data sets that are incorporated into design software, such as the Exocad program. It is no longer necessary - but even contraindicated - to use an analogue articulator, as this would be far too imprecise in its motion sequences compared to the digital articulator of the present invention, even with the most precise programming by analogue or digital pantography.

A method of manufacturing and possibly inserting a veneer into a denture of a person according to a second aspect more quickly results in the result of an inserted veneer in the dentition of the person.

Reference is made to claim 6. In that all the steps of obtaining the data sets required for the milling process are done digitally - ie the creation of the mid-face and lower-face volumetric images, the creation of the intraoral scan of the maxillary and mandibular teeth, the pantographic recording of the articular path and the detection of the face by one Facial scan (both static and dynamic) - it is possible, without having to create an analogous model by a dental technician, to immediately manufacture the veneer in the dental office when the milling machine is in the dental office. The time delay incurred so far by interposing the model creation by the dental technician thus eliminated, and the veneer can be glued directly to the person in an appointment with a short wait. The person does not have to come to the dentist for a second time, which saves both the dentist and the person time. In addition, the inventive method can be performed not only faster, but also cheaper than the previous method.

An advantageous development of the invention provides that between the steps of the milling of the veneer and the insertion of the veneer, the veneer is fired in a zirconia. As a result, special zirconium restorations can also be carried out.

A further advantageous development of the invention provides that the three-dimensional bone and tooth ratios of the person are determined during the creation of the digital volume tomogram. This allows a more accurate determination of the required shape of the veneer done, as if, for example, only the tooth conditions by an impression by means of impression material - as is done in the prior art - are determined.

A further advantageous development of the invention provides that the first data record is a DICOM data record and / or the second data record is an STL data record and / or the third data record is an STL data record and / or the fourth data record is an OBJ data record. As a result, standard devices can be used to create the records and the resulting records can be used within a standard software for a digital articulator.

A further advantageous development of the invention provides that in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt triangle, individual anterior guidance. Based on these measurements, a reliable creation of the digital articulator is possible.

A further advantageous embodiment of the invention provides that in the digital detection of the face, the static recordings include a face photograph and / or a profile photo and / or a smile photo and / or wherein in the digital detection of the face, the dynamic movements recording a mimic action and / or an opening of the mouth and / or a laughing process. Based on these values, an ideal setting of the virtual model in the digital articulator is possible.

A further advantageous embodiment of the invention provides that the digital articulator contains the data for the individual values of the person and its anatomical hinge axis. This allows the veneer to be adapted even better to the circumstances of the person, since not only the static values - such as teeth clenched - flow into, but also the dynamic values during chewing.

A further advantageous development of the invention provides that a five-axis milling machine is used as the milling machine. Such milling machines are reliable and can easily make all possible shapes of the veneer.

A further advantageous embodiment of the invention provides that all data of the person are transferred to a tablet computer and there the teeth and the veneer are displayed in selectable states. With this, the person can still be visualized on the dental chair, as the denture with the glued veneer will look like.

Further advantages and details of the invention will be explained with reference to an embodiment.

A digital volume tomogram of the middle and lower face is created by the person to whom a veneer is to be adhered to the dentition; The three-dimensional bone and tooth conditions of the person are recorded. For this creation, for example, the device ORTHOPANTOMOGRAPH OP300 of the manufacturer KaVo Dental GmbH will be used. The first record thus obtained is in a DICOM format. DICOM stands for Digital Imaging and Communications in Medicine and is a standard format for medical data. The first data record is transmitted by means of known transmission methods - for example wirelessly by means of WLAN or Bluetooth or wired via a USB interface - to a computer unit and stored there.

The oral situation is also determined by means of an intraoral scan of the maxillary and mandibular teeth. This is done by means of a suitable scan camera, for example the CEREC Omnicam from the manufacturer Sirona Dental GmbH. In this case, a second data record is obtained in an STL format. STL stands for STereoLithography. Also, the second record is - as the first record - transmitted by known transmission paths to the computer unit and stored there.

There is also a digital measurement of the joint track by pantographic recording. For this purpose, for example, the jaw registration system JMA system of the manufacturer zebris Medical GmbH is used. All information is obtained - such as the maxillary HCI angle, the horizontal condylar path inclination, the Bennett angle, the Posselt triangle and the individual anterior guidance - in order to be able to determine the setting values for a digital articulator. This happens in a given measurement sequence - such as by lower jaw movements such as protrusion and laterotrusion. In this case, a third data record is obtained in an STL format. Also, the third record is - like the other two records - transmitted by known transmission paths to the computer unit and stored there.

There is also a digital capture of the face. This provides that by means of the face scanner both the static states - for example by a face photograph, a frontal photo or a smile photo - and the dynamic states - for example, the facial expressions, an opening process of the mouth or a laughing process - recorded and recorded. This is done by means of a known from the prior art face scanner, such as the model FACE HUNTER ZIRKONZAHN GmbH. On the basis of the values obtained, an individual adjustment of the virtual model into the digital articulator is possible. A fourth record in an OBJ format is obtained. OBJ stands for "object" and is a file format for the description of geometric objects. Also, the fourth record is - like the other three records - transmitted via known transmission paths to the computer unit and stored there.

The order of the above four steps of creating the volume tomogram, the creation of the intraoral scan, the pantograph recording of the articular path and the creation of the facial scan can be done in any order. They are performed regularly one after the other as long as the person is lying on the dental chair with the dentist.

The above-mentioned four data sets are used in a software suitable for this purpose, for example the exocad DentalCAD design software from exocad GmbH, to create a digital articulator which has all the individual values of the person together with their anatomical hinge axis.

As a result, it is no longer necessary to have a physically existing articulator created by a dental technician. Thus, the cost of materials is reduced and - more importantly - the time required to create the articulator considerably shortened.

In contrast to the previous procedure in a physical articulator, in which a wax model of the veneer is waxed at the point at which the veneer is to be glued to the denture later, which then leads to the ceramic veneer by means of complicated procedures, can in the inventive Method, the shape of the veneer directly on the screen, for example by means of the above-mentioned design software exocad DentalCAD, set and the resulting fifth dataset are used for the production of the ceramic veneer. This fifth data set is transferred by means of known transmission methods - wirelessly or by cable - to a five-axis milling machine, for example the model inLab MC X5 from the manufacturer Sirona Dental GmbH. The milling and grinding process, as known from the prior art, by machining a selected blank - for example, a ceramic zirconia. In this case, the data of the fifth data record is used.

This saves an enormous amount of time compared to the method of the prior art, since, inter alia, no dental technician outside the dental practice must be consulted. The preparation of the ceramic veneer can begin immediately after the determination of the shape of the veneer and the associated creation of the fourth record.

After a short time, the veneer is ready and can be immediately glued into the dentition of the person.

Since all devices required for carrying out the method according to the invention can be used or set up easily in the dental practice with practice-own laboratories, everything can be carried out in a continuous workflow - ie everything bundled under one roof - and the person does not yet have to paste the veneer Once at a later date - after the dental technician has made the veneer and sent it to the dental office - come to the dental office.

Another advantage of the method according to the invention is that the person can be shown on the screen before creating the veneer, as the veneer looks in the dented state in the dentition. All that is required is to transfer all the data of the person obtained from the first, second, third and fourth data sets and additionally the fifth data set representing the veneer to a tablet computer. There, the dentition and the veneer can then be displayed in selectable states. The person can then stop this production even before the transmission of the fifth data set to the milling machine and the beginning of the production of the veneer, if he does not like the virtual result displayed on the tablet computer. A new fifth record can then be created that results in a different shape of the veneer. This result can then be shown to the person again on the tablet computer. This process can be repeated until the person is satisfied with the result presented - there is then no "rude awakening" when the veneer is glued in and the overall impression of the dentition does not match the person's imagination.

In the method according to the invention, CAI (Computer Aided Imaging) - in the creation of the first, second, third and fourth data record - CAD (Computer Aided Design) - when creating the fifth data set - and CAM (Computer Aided Manufacturing) - when milling of the veneer - together. The required equipment including computer programs and memory for the data obtained can all be easily kept in stock in the dental office, so that no additional time is incurred by the involvement of a foreign dental technician laboratory. Thus, the person only has to go to the dentist once more and, immediately after taking his data and creating the data for the veneer, he glues the veneer made in the dental practice.

The invention enables a "digital dentist's practice" with an analog digital workflow in an interdisciplinary treatment concept.

This innovation is the result of 10 years of research work by the industry and specialist laboratories on the holistic digital age of dentistry.

With the invention advantages of technology are used, facilitating the daily routines and, above all, increases the speed with which patients are spared many hours of practice.

The technical advantage allows the practice to serve more patients and to go short distances with exceptional results and to ensure the utilization of their own laboratory.

The truly revolutionary idea is the academic achievement of digitally networking digital single dental devices through communicating interfaces within a single dental office or even spatially separated collaborative dental units completed into a complete digital workflow for dental-functional / therapeutic and / or prosthetic restoration a patient.

• – Verringerung der zahnärztlichen Patientenzeiten am Behandlungsstuhl,
• – damit verbunden die Verringerung von körperlichen Beeinträchtigungen des Patienten,
• – Verringerung der Personal- und Fertigungseinsätze,
• – Materialeinsparung,
• – Reproduzierbarkeit 1:1 ohne erneute Behandlung am Behandlungsstuhl.

The purpose is, among others:

• Reduction of dental patient times at the treatment chair,
• - associated with the reduction of physical disabilities of the patient,
• - reduction of personnel and manufacturing operations,
• - material saving,
• - Reproducibility 1: 1 without re-treatment at the chair.

Proposed is the networking of all of a dental scientifically recognized, functionally and aesthetically-oriented digital workflow necessary individual devices for enabling a fully digital anatomy and functionally accurate dental practice.

The invention in this context, but also independently, a method for using an electronic technique (CAI-CAD-CAM) for producing a patient-specific, functionally and anatomically accurate Tooth replacement by means of an electronic-based articulator ready.

In this context, but also independently of this, the invention further provides a virtual electronic patient-individual articulator, which is also referred to below as "individual virtual articulator", in short "IVA".

General description / differences of the IVA to the existing articulators

Differences to already known so-called virtual articulators and the analog articulators include the following:
The individual articulator, the patient's own and accurate anatomy and function of the teeth and jaws can be adjusted individually in the virtual articulator, this can not to date all the above articulators, usually had to fulfill the requirement for high quality, etc. in the field of dentistry Functionally oriented aspects then usually still with plaster models in the analog articulator or this then scanned into the so-called virtual articulator, but which are only approximate to anatomical and functional structures of the patient to be worked.

The invention provides an absolutely true patient-specific articulator, which can also be designated as a purely patient-specific genuine virtual or digital plaster model-free articulator. The IVA according to the invention is distinguished by the fact that none with an arbitrary - i. The individual patient hinge axis only needs to be scanned into approximated facebow-articulated models and inserted into the Exocad software as an STL dataset. According to the invention, it is no longer necessary, but even contraindicated, to use an analogue or spurious virtual articulator, since this would be far too imprecise in the movement sequences, even with the most precise programming by means of an analogue or digital pantography.

It should also be mentioned again for clarification that a dental technician with the Individual Virtual Articulator will in future no longer need a plaster model in the laboratory and no analogue patient impressions from the mouth in order to produce high-quality functional and anatomical dentures that exactly match the patient's conditions.

The disadvantages of the method with the previous analog or spurious virtual articulator are the inaccurate and indirect determination of the anatomical and functional data as well as in particular the generally missing adjustment of the necessary anatomical and functional parameters. In particular, all previously existing analog and spurious virtual articulator systems dictate the average intercondylar space, which does not correspond to the anatomical reality of the individual patient.

Exemplary description of the IVA

The digital volume tomogram (DVT) is a radiographic spatial, so 3D rendering, the patient-specific anatomy, such. Temporomandibular joint and bone anatomy and position, with a current voxel size of about 100 ym = 100/1000 mm.

The temporomandibular joint anatomy may also show an arthritic change in the condyle and yet this condyle may be in the correct centric position.

By means of the DVT, a measurement of the intercondylar distance is possible by means of the radiographic reproduction of the condylar position in the patient-specific 3D space. The condyluscorpusräumliche center is the reference point.

Preferably, the CBCT should be at maximum maximum point contact of both jaws when created. This is realized by the so-called "habitual maximum intercuspidation", i. a slightly open jaw retention would not be value-altering to about 2mm, as the condyles are still in pure rotation at the initial mouth opening.

In a functional recording of the lower jaw movements, the spatial patient-specific movement of the lower jaw, e.g. the transverse condylar path inclination or latero- / pro-trusion, as well as the mouth opening shown.

Thus, one could virtually separate the mandible from the skull, because the lower jaw movements are unique by the pantograph record, this could be determined by means of e.g. Zebris recording to move exactly as on the living patient.

The models can be viewed using a digital scan camera, e.g. with the Omnicam scan camera, to be scanned. The individual jaws can be shaped in 1-2 minutes and simultaneously displayed as a 3D image on the monitor.

The facial presentation can be made by using a digital video camera in a short video to create an aesthetically-matched prosthesis, the individual face conditions, e.g. Lips, smile line etc. of the patient can be displayed.

• 1. Scan Modelle – mit STL Datensatz, z.B. OK-UK-Digitalabformung.
• 2. Scan DVT mit Dicom Datensatz, z.B. KaVo OP300.
• 3. Digitale Übertragung der statischen UND vor allem dynamischen Bewegungen des UK, mit STL Datensatz, z.B. Zebris JMA. optional
• 4. Digitale Übertragung der Gesichtsstrukturen zur ästhetischen Gestaltung des Zahnersatzes mit xml, obj Datensatz, z.B. Syncc Kamera Zebris.

Required records for the IVA include:

• 1. Scan models - with STL data set, eg OK-UK digital impression.
• 2. Scan DVT with Dicom data set, eg KaVo OP300.
• 3. Digital transmission of the static AND especially dynamic movements of the UK, with STL record, eg Zebris JMA. optional
• 4. Digital transmission of the facial structures for the aesthetic design of the denture with xml, obj data set, eg Syncc Camera Zebris.

The true patient-individual virtual articulator can be simulated by matching all 3 (and optional 4.) datasets above and programming the individual movement of the mandible by software in 3D space by, e.g. digital imaging techniques, e.g. a DVT with digital surveying techniques such. Zebris - pantographic facebow recorder by means of ultrasound transmitter / receiver - can be linked together.

For this purpose, the measured individual temporomandibular joint data (zebris) of the same patient must be correlated to the patient after the imaging measures (DVT), which is referred to as "matching".

The matching can be done as follows:
Through the process of the mathematical algorithm, data can be brought into the resolution of the other by the transfer by means of algorithmic application, eg by using the program Aadva-Manager specialized for the transfer of data records with the application DICOM Viewer, which is activated from the software EXOCAD, the DICOM data of the DVT, eg exported from the KaVo software Cliniview. Here, for example, the best fit adaptation is selected. Now one brings STL data, eg from the Omnicam scan data set (upper jaw scan) or the data set of the Zebrisunterkiefermodells, currently 20 ym as a surface model into the Dicomdaten spatially still inaccurate DVT voxel size, currently 100 ym, by at least 3 anatomically exactly same points eg of the scan model with the exact same points of the DVT's marked / equated.

Thus, the complete parameters of the patient-specific anatomy of his jaw, teeth and bone structures can be defined by means of the DVT recording and the recorded data of the lower jaw movements, e.g. from the functional registration system - here Zebrissystem - be brought into relation by, i.a. the record of the DVT Dicom record e.g. exported from the KaVo software Cliniview, as well as the STL data set e.g. the Pantografie-Gelenkbahnen recording - here zebris JMA - in the interfaces (again Aadva manager, Dicom viewer, best fit), the designated designer software - here Exocad - brings, and these with the so-called "matching" correlated and thus exactly matched.

• 1. Verfahren zur Herstellung und zum Einsetzen eines Veneers in ein Gebiss einer Person mit folgenden Schritten: – Erstellung eines digitalen Volumentomogramms des Mittelgesichts und des Untergesichts der Person mittels eines Röntgengeräts und Übertragung des dabei erhaltenen ersten Datensatzes zu einer Rechnereinheit; – digitale pantographische Aufzeichnung der Gelenkbahn der Person und Übertragung des dabei erhaltenen zweiten Datensatzes zu der Rechnereinheit; – Verwendung des ersten Datensatzes und des zweiten Datensatzes zur Erstellung eines digitalen Artikulators mittels eines Computerprogramms, wobei die Daten des ersten Datensatzes anhand des durchgeführten bildgebenden Verfahrens mittels des digitalen Volumentomogramms mit den gemessenen individuellen Kiefergelenks-Daten in die richtige Relation gebracht werden, wobei dies durch die Anwendung von personenspezifischen, anatomischen Gegebenheiten realisiert wird; – Berechnung der Form des Veneers und der Stelle im Gebiss der Person, an der das Veneer angebracht werden soll, aus den Daten des digitalen Artikulators als fünften Datensatz und Übertragung des fünften Datensatzes zu einer Fräsmaschine; – Fräsen des Veneers in der Fräsmaschine aus einem Rohling mittels der Daten des fünften Datensatzes.
• 2. Verfahren nach Gegenstand 1, wobei das in die richtige Relation bringen von erstem Datensatz und zweitem Datensatz durch die Definition der Frankfurter Horizontalen oder einer anderen anatomischen schädelbezüglichen individuellen Dimension des Patienten anhand des ersten Datensatzes mit in Relation bringen der aufgezeichneten Daten der Unterkieferbewegung des zweiten Datensatzes erfolgt.
• 3. Verfahren nach einem der vorstehenden Gegenstände, wobei als weiterer Schritt vor der Erstellung des digitalen Artikulators eine Erstellung eines intraoralen Scans der Oberkieferzähne und der Unterkieferzähne der Person mittels einer intraoralen Scankamera und Übertragung des dabei erhaltenen dritten Datensatzes zu der Rechnereinheit erfolgt.
• 4. Verfahren nach einem der vorstehenden Gegenstände, wobei als weiterer Schritt vor der Erstellung des digitalen Artikulators eine digitale Erfassung des Gesichts durch statische Aufzeichnungen und der dynamischen Bewegungen mittels eines Gesichtsscanners und Übertragung des dabei erhaltenen vierten Datensatzes zu der Rechnereinheit.
• 5. Verfahren nach einem der vorstehenden Gegenstände, wobei ein Einsetzen des Veneers bei der Person durch aufkleben an der vorgegebenen Stelle am Gebiss der Person erfolgt.
• 6. Verfahren nach Gegenstand 5, wobei zwischen den Schritten des Fräsens des Veneers und dem Einsetzen des Veneers das Veneer in einem Zirkonofen gebrannt wird.
• 7. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der Erstellung des digitalen Volumentomogramms die dreidimensionalen Knochen- und Zahnverhältnisse der Person ermittelt werden.
• 8. Verfahren nach einem der vorstehenden Gegenstände, wobei der erste Datensatz ein DICOM-Datensatz und/oder der dritte Datensatz ein STL- oder XML-Datensatz und/oder der zweite Datensatz ein STL-Datensatz und/oder der vierte Datensatz ein OBJ-Datensatz ist.
• 9. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen pantographischen Aufzeichnung mindestens einer der folgenden Messwerte gemessen werden: Oberkiefer-HCI-Winkel, horizontale Kondylenbahnneigung, Benettwinkel, Posseltsches Dreieck, individuelle Frontzahnführung.
• 10. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen Erfassung des Gesichts die statischen Aufzeichnungen ein Gesichtsphoto und/oder ein Profilphoto und/oder ein Lachphoto umfassen.
• 11. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen Erfassung des Gesichts die dynamischen Bewegungen die Aufzeichnung einer mimischen Aktion und/oder einer Öffnung des Mundes und/oder eines Lachvorgangs umfassen.
• 12. Verfahren nach einem der vorstehenden Gegenstände, wobei der digitale Artikulator die Daten für die individuellen Werte der Person und dessen anatomische Scharnierachse enthält.
• 13. Verfahren nach einem der vorstehenden Gegenstände, wobei als Fräsmaschine eine Fünfachsen-Fräsmaschine verwendet wird.
• 14. Verfahren nach einem der vorstehenden Gegenstände, wobei alle Daten der Person auf einen Tablett-Computer übertragen werden und dort das Gebiss und das Veneer in auswählbaren Zuständen dargestellt werden.

According to the first aspect, among others, the following items are provided:

• 1. A method for producing and inserting a veneer in a dentition of a person with the following steps: - Creation of a digital volume tomogram of the midface and the lower face of the person by means of an X-ray device and transmission of the first data set obtained to a computer unit; Digital pantographic recording of the person's joint track and transmission of the second data record obtained thereby to the computer unit; Use of the first data set and the second data set for creating a digital articulator by means of a computer program, wherein the data of the first data set by means of the performed imaging process by means of the digital volume tomogram with the measured individual temporomandibular joint data in the right relation, by the application of person-specific, anatomical conditions is realized; Calculating the shape of the veneer and the location in the dentition of the person to whom the veneer is to be applied, from the data of the digital articulator as the fifth data set and transferring the fifth data set to a milling machine; - Milling the veneer in the milling machine from a blank by means of the data of the fifth record.
• 2. The method of item 1, wherein bringing the first data set and second data set into correct relation by defining the Frankfurt horizontal or other anatomical cranial individual dimension of the patient from the first data set correlates the recorded data of the mandibular motion of the second one Record is done.
• 3. The method according to any one of the preceding objects, wherein as a further step before the creation of the digital articulator a creation of an intraoral scan of the maxillary teeth and the mandibular teeth of the person by means of an intraoral scanning camera and transmission of the resulting third data set to the computer unit.
• 4. The method according to one of the preceding objects, wherein as a further step prior to the creation of the digital articulator, a digital detection of the face by static records and the dynamic movements by means of a face scanner and transmission of the fourth data set thereby obtained to the computer unit.
• 5. The method according to one of the preceding objects, wherein an insertion of the veneer takes place at the person by sticking to the predetermined location on the dentition of the person.
• 6. The method of item 5, wherein between the steps of milling the veneer and inserting the veneer, the veneer is fired in a zirconia oven.
• 7. The method according to any one of the preceding objects, wherein in the preparation of the digital volume tomogram, the three-dimensional bone and tooth ratios of the person are determined.
• 8. Method according to one of the preceding objects, wherein the first data record is a DICOM data record and / or the third data record is an STL or XML data record and / or the second data record is an STL data record and / or the fourth data record is an OBJ data record is.
• 9. Method according to one of the preceding objects, wherein in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt's triangle, individual anterior guidance.
• 10. The method according to one of the preceding objects, wherein in the digital detection of the face, the static recordings include a face photograph and / or a profile photo and / or a smile photo.
• 11. The method according to one of the preceding objects, wherein in the digital detection of the face, the dynamic movements include the recording of a mimic action and / or an opening of the mouth and / or a laugh process.
• 12. The method of any preceding item, wherein the digital articulator includes the data for the individual values of the subject and the anatomical hinge axis thereof.
• 13. The method according to any one of the preceding objects, wherein a five-axis milling machine is used as a milling machine.
• 14. A method according to any one of the preceding claims, wherein all data of the person is transferred to a tablet computer and there the denture and the veneer are presented in selectable states.

• 1. Verfahren zur Herstellung und zum Einsetzen eines Veneers in ein Gebiss einer Person mit folgenden Schritten: – Erstellung eines digitalen Volumentomogramms des Mittelgesichts und des Untergesichts der Person mittels eines Röntgengeräts und Übertragung des dabei erhaltenen ersten Datensatzes zu einer Rechnereinheit; – Erstellung eines intraoralen Scans der Oberkieferzähne und der Unterkieferzähne der Person mittels einer intraoralen Scankamera und Übertragung des dabei erhaltenen zweiten Datensatzes zu der Rechnereinheit; – digitale pantographische Aufzeichnung der Gelenkbahn der Person und Übertragung des dabei erhaltenen dritten Datensatzes zu der Rechnereinheit; – digitale Erfassung des Gesichts durch statische Aufzeichnungen und der dynamischen Bewegungen mittels eines Gesichtsscanners und Übertragung des dabei erhaltenen vierten Datensatzes zu der Rechnereinheit; – Verwendung des ersten Datensatzes, des zweiten Datensatzes, des dritten Datensatzes und des vierten Datensatzes zur Erstellung eines digitalen Artikulators mittels eines Computerprogramms; – Berechnung der Form des Veneers und der Stelle im Gebiss der Person, an der das Veneer angebracht werden soll, aus den Daten des digitalen Artikulators als fünften Datensatz und Übertragung des fünften Datensatzes zu einer Fräsmaschine; – Fräsen des Veneers in der Fräsmaschine aus einem Rohling mittels der Daten des fünften Datensatzes; – Einsetzen des Veneers bei der Person durch aufkleben an der vorgegebenen Stelle am Gebiss der Person.
• 2. Verfahren nach Gegenstand 1, wobei zwischen den Schritten des Fräsens des Veneers und dem Einsetzen des Veneers das Veneer in einem Zirkonofen gebrannt wird.
• 3. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der Erstellung des digitalen Volumentomogramms die dreidimensionalen Knochen- und Zahnverhältnisse der Person ermittelt werden.
• 4. Verfahren nach einem der vorstehenden Gegenstände, wobei der erste Datensatz ein DICOM-Datensatz und/oder der zweite Datensatz ein STL-Datensatz und/oder der dritte Datensatz ein STL-Datensatz und/oder der vierte Datensatz ein OBJ-Datensatz ist.
• 5. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen pantographischen Aufzeichnung mindestens einer der folgenden Messwerte gemessen werden: Oberkiefer-HCI-Winkel, horizontale Kondylenbahnneigung, Benettwinkel, Posseltsches Dreieck, individuelle Frontzahnführung.
• 6. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen Erfassung des Gesichts die statischen Aufzeichnungen ein Gesichtsphoto und/oder ein Profilphoto und/oder ein Lachphoto umfassen.
• 7. Verfahren nach einem der vorstehenden Gegenstände, wobei bei der digitalen Erfassung des Gesichts die dynamischen Bewegungen die Aufzeichnung einer mimischen Aktion und/oder einer Öffnung des Mundes und/oder eines Lachvorgangs umfassen.
• 8. Verfahren nach einem der vorstehenden Gegenstände, wobei der digitale Artikulator die Daten für die individuellen Werte der Person und dessen anatomische Scharnierachse enthält.
• 9. Verfahren nach einem der vorstehenden Gegenstände, wobei als Fräsmaschine eine Fünfachsen-Fräsmaschine verwendet wird.
• 10. Verfahren nach einem der vorstehenden Gegenstände, wobei alle Daten der Person auf einen Tablett-Computer übertragen werden und dort das Gebiss und das Veneer in auswählbaren Zuständen dargestellt werden.

According to the second aspect, among others, the following items are provided:

• 1. A method for producing and inserting a veneer in a dentition of a person with the following steps: - Creation of a digital volume tomogram of the midface and the lower face of the person by means of an X-ray device and transmission of the first data set obtained to a computer unit; - Creation of an intra-oral scan of the maxillary and mandibular teeth of the person by means of an intra-oral scanning camera and transfer of the resulting second data set to the computer unit; Digital pantographic recording of the person's joint path and transmission of the third data set thus obtained to the computer unit; Digital acquisition of the face by static recordings and the dynamic movements by means of a facial scanner and transmission of the fourth data set thus obtained to the computer unit; Using the first data record, the second data record, the third data record and the fourth data record to create a digital articulator by means of a computer program; Calculating the shape of the veneer and the location in the dentition of the person to whom the veneer is to be applied, from the data of the digital articulator as the fifth data set and transferring the fifth data set to a milling machine; - Milling the veneer in the milling machine from a blank by means of the data of the fifth record; - Insert the veneer into the person by sticking it in place at the dentition of the person.
• 2. The method of item 1, wherein between the steps of milling the veneer and inserting the veneer, the veneer is fired in a zirconia furnace.
• 3. The method according to any one of the preceding objects, wherein in the preparation of the digital volume tomogram, the three-dimensional bone and tooth ratios of the person are determined.
• 4. Method according to one of the preceding objects, wherein the first data record is a DICOM data record and / or the second data record is an STL data record and / or the third data record is an STL data record and / or the fourth data record is an OBJ data record.
• 5. Method according to one of the preceding objects, wherein in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal condylar path inclination, Benett angle, Posselt's triangle, individual anterior guidance.
• 6. Method according to one of the preceding objects, wherein in the digital acquisition of the face the static recordings comprise a face photograph and / or a profile photo and / or a smile photo.
• 7. Method according to one of the preceding objects, wherein in the digital detection of the face the dynamic movements comprise the recording of a mimic action and / or an opening of the mouth and / or a laughter process.
• 8. The method of any preceding item, wherein the digital articulator includes the data for the individual values of the subject and the anatomical hinge axis thereof.
• 9. The method according to any one of the preceding objects, wherein a five-axis milling machine is used as a milling machine.
• 10. The method of any one of the preceding claims, wherein all data of the person is transferred to a tablet computer and there the denture and the veneer are displayed in selectable states.

Claims (22)

Process for the integrated production of dental prostheses for a person consisting of: A) transmission of a digital volume tomogram of the face of the person, including the lower jaw and upper jaw of the person, to a computer unit, B) transmission of a digital pantographic recording of the person's joint path to the computer unit, C) creating a digital articulator from steps A) and B) in the computer unit, D) transmission of the digital data of the articulator to a manufacturing unit, and E) Production of the denture by means of the production unit. Process for the preparation of dentures in a dentition of a person with the following steps: - Creation of a digital volume tomogram of the mid-face and a lower face of the person by means of a radiological imaging device, for example, such as an X-ray device and transmission of the resulting first data set to a computer unit; Digital pantographic recording of the person's joint track and transmission of the second data record obtained thereby to the computer unit; Use of the first data set and the second data set for creating a digital articulator by means of a computer program, wherein the data of the first data set by means of the performed imaging process by means of the digital volume tomogram with the measured individual temporomandibular joint data in the right relation, by the application of person-specific, anatomical conditions is realized; - calculating the shape of the denture and the location in the dentition of the person to whom the denture is to be attached, from the data of the digital articulator as the fifth data set and transferring the fifth data set to a manufacturing facility; - Production of the denture in the manufacturing facility from a blank by means of the data of the fifth record. A method according to claim 2, wherein the bringing into correct relation of the first data set and the second data set by the definition of the Frankfurt horizontal or other anatomical craning individual dimension of the person on the basis of the first data set is in relation to the recorded data of the lower jaw movement of the second data set , Method according to one of the preceding claims, wherein as a further step prior to the creation of the digital articulator, an establishment of an intraoral scan of the maxillary teeth and the mandibular teeth of the person by means of an intraoral scanning camera and transmission of the thereby obtained third data set to the computer unit. Method according to one of the preceding claims, wherein as a further step before the creation of the digital articulator, a digital detection of the face by static records and / or the dynamic movements by means of a face scanner and transmission of the fourth data set obtained thereby to the computer unit. A method for producing dental prosthesis in a dentition of a person with the following steps: - Creation of a digital volume tomogram of the midface and the lower face of the person by means of an X-ray device and transmission of the first data set thereby obtained to a computer unit; - Creation of an intra-oral scan of the maxillary and mandibular teeth of the person by means of an intra-oral scanning camera and transfer of the resulting second data set to the computer unit; Digital pantographic recording of the person's joint path and transmission of the third data set thus obtained to the computer unit; Digital acquisition of the face by static recordings and the dynamic movements by means of a facial scanner and transmission of the fourth data set thus obtained to the computer unit; Use of at least one of the first data record, the second data record, the third data record and the fourth data record for the creation a digital articulator by means of a computer program; - calculating the shape of the denture and the location in the dentition of the person to whom the denture is to be attached, from the data of the digital articulator as the fifth data set and transferring the fifth data set to a manufacturing facility; - Production of the denture in the manufacturing facility from a blank by means of the data of the fifth record. Method according to one of the preceding claims, wherein an insertion of the denture in the person takes place at the predetermined location on the dentition of the person. The method of claim 7, wherein the insertion of the dental prosthesis is done by sticking. A method according to claim 7 or 8, wherein between the steps of manufacturing the denture and inserting the denture, the denture is fired in a zirconia furnace. Method according to one of the preceding claims, wherein in the preparation of the digital volume tomogram, the three-dimensional bone and tooth ratios of the person are determined. Method according to one of the preceding claims, wherein the first data record is a DICOM data record and / or the third data record is an STL or XML data record and / or the second data record is an STL data record and / or the fourth data record is an OBJ data record. Method according to one of the preceding claims, wherein in the digital pantographic recording at least one of the following measured values are measured: maxillary HCI angle, horizontal Kondylenbahnneigung, Benettwinkel, Posselt triangle, individual anterior guidance. Method according to one of the preceding claims, wherein in the digital detection of the face the static recordings comprise a face photograph and / or a profile photo and / or a smile photo. Method according to one of the preceding claims, wherein in the digital detection of the face, the dynamic movements comprise the recording of a mimic action and / or an opening of the mouth and / or a laugh process. Method according to one of the preceding claims, wherein the digital articulator contains the data for the individual values of the person and its anatomical hinge axis. Method according to one of the preceding claims, wherein all data of the person are transferred to a tablet computer and there the denture and the dentures are presented in selectable states. A method according to any one of the preceding claims, wherein the dental prosthesis comprises a veneer, a crown, a bridge, a partial implant, a full implant, a prosthesis or a combination thereof. Method according to one of the preceding claims, wherein the production of the dental prosthesis by milling the denture from a blank or / and by sintering a blank, for example using a laser and / or made by 3D printing from a blank and / or grinding a blank. Method according to one of the preceding claims, wherein a milling machine, preferably a five-axis milling machine is used as a manufacturing device for producing the dental prosthesis. Method according to one of the preceding claims, wherein the dental prosthesis is made of metal and / or ceramic or / and plastic. System for carrying out the method according to one of the preceding claims, comprising a plurality of specialized functions performing units, which are or can be brought into data communication with one another, for the transmission of data to be transmitted between the units according to the method for the production of dental prostheses. A digital virtual articulator for use in the system of claim 21 or in the method of any one of claims 1 to 20.