Method and system for 3D root canal treatment planning
A three-dimensional computer model of the patient's tooth, including the pulp chamber and root canals, is created by combining at least one grey value image of the tooth and/or surface information about at least part of the intra-orally visible part of the tooth with a statistical, parameterized shape model of each tooth type (upper or lower incisors, canines, pre-molars, molars) as the patient's tooth to be treated. This allows for planning and/or simulation of one or more root canal treatments on the computer model of the patient's tooth and that the dentist or dental specialist is given qualitative and/or quantitative information by the system in order to aid in adequately analyzing the risks related to performing the root canal treatment with the proposed or user-selected endodontic tools.
1. A method for 3D planning of the restoration of a tooth comprising the steps of:
generating and visualizing a 3D model of the tooth to be restored by combining at least one piece of tooth specific digital information with a statistical, parameterized shape model of the relevant tooth type, wherein the 3D model includes the root canals and pulp chamber;
planning or simulating a root canal treatment on the generated 3D model of the tooth creating a post-treatment 3D model of the tooth;
allowing determining the dimensions of a core build-up to replace missing tooth material in the post-treatment 3D model in order to strengthen the tooth to prevent breakage;
creating a crown restoration on the post-treatment 3D tooth model by importing a wax-up or by selecting, positioning, and adapting a crown from a library of crowns in the post-treatment 3D model of the tooth, or by mirroring the existing contra-lateral crown of the patient, or by using a statistical model for fitting a crown in between the neighboring teeth of the tooth to be restored;
creating a visualization on the post-treatment 3D model of the tooth of a quantitative feedback of the available thickness of the remaining material of the tooth for the restorative crown and estimate the risk of fracture of the crown or possible crown perforations; and
selecting or determining an optimal core build-up and sequence of treatment steps for the crown restoration for ensuring tooth strength and successful crown restoration.
2. The method of claim 1 , wherein the step of allowing determining the dimensions of a core build-up to replace missing tooth material in the post-treatment 3D model in order to strengthen the tooth to prevent breakage comprises providing automatically an ideal core-build up.
3. The method of claim 1 , wherein the step of allowing determining the dimensions of a core build-up to replace missing tooth material in the post-treatment 3D model in order to strengthen the tooth to prevent breakage comprises providing tools for the user for manually creating a core build up.
4. The method of claim 1 , comprising the further steps of:
allowing selecting of a post to provide retention for the crown restoration from a library of posts and positioning it in the reamed root canal of the post-treatment 3D model of the tooth;
creating a visualization on the post-treatment 3D model of the tooth of a quantitative feedback on the risk of perforation or the risk of fracture of the tooth root as a result of the post positioning; and
selecting or determining the optimal post and post position in order to reduce clinical risks or failure of the crown restoration, wherein this step develops a sequence of treatment steps for the preparation of the cavity and root canal for the post.
5. The method of claim 4 , wherein the post is automatically selected from a library of posts based on one or a combination of the following criteria: post with dimensions that best fit the dimensions of the reamed root canal of the post-treatment 3D tooth model, post with dimensions that minimally circumscribes the reamed root canal of the post-treatment 3D tooth model, post with dimensions that ensures a minimal root wall thickness around the post, post with dimensions that limits the risk of tooth fracture.
6. The method of claim 4 , wherein the post is manually selected from a library of posts.
7. The method of claim 4 , wherein the post is automatically positioned in the post-treatment 3D model of the tooth.
8. The method of claim 4 , wherein the post is manually positioned in the post-treatment 3D model of the tooth.
9. The method of claim 4 , wherein the visualization on the post-treatment 3D model of the tooth of a quantitative feedback on the risk of perforation or the risk of fracture of the tooth root as a result of the post positioning comprises a visualization of the intersections between the post and the post-treatment 3D tooth model by color marking either the part of the surface of the post that is outside the post-treatment 3D tooth model or the intersection lines between the post and the post-treatment 3D tooth model.
10. The method of claim 5 , wherein the visualization on the post-treatment 3D model of the tooth of a quantitative feedback on the risk of perforation or the risk of fracture of the tooth root as a result of the post positioning comprises a visualization of the root thickness around the post; and wherein the risk of perforation is quantified based on clinically accepted threshold values for the root thickness around the post.
11. The method of claim 4 , wherein the risk of perforation is quantified by using a statistical model.
12. The method of claim 1 , wherein the 3D model is obtained from 2D grey value image(s) of patient's tooth and 3D surface information of an intra-orally visible part of patient's tooth.
13. The method according to claim 12 wherein the 2D grey value image(s), 3D surface information and statistical, parametrized shape model of each tooth type are loaded in a computer.
14. The method of claim 5 , wherein the risk of perforation is quantified by using a statistical model.
15. The method of claim 6 , wherein the risk of perforation is quantified by using a statistical model.
16. The method of claim 7 , wherein the risk of perforation is quantified by using a statistical model.
17. The method of claim 2 , wherein the 3D model is obtained from 2D grey value image(s) of patient's tooth and 3D surface information of an intra-orally visible part of patient's tooth.
18. The method of claim 2 , further comprising the steps of:
allowing selecting of a post to provide retention for the crown restoration from a library of posts and positioning it in the reamed root canal of the post-treatment 3D model of the tooth;
creating a visualization on the post-treatment 3D model of the tooth of a quantitative feedback on the risk of perforation or the risk of fracture of the tooth root as a result of the post positioning; and
selecting or determining the optimal post and post position in order to reduce clinical risks or failure of the crown restoration, wherein this step develops a sequence of treatment steps for the preparation of the cavity and root canal for the post.
19. The method of claim 3 , further comprising the steps of:
allowing selecting of a post to provide retention for the crown restoration from a library of posts and positioning it in the reamed root canal of the post-treatment 3D model of the tooth;
creating a visualization on the post-treatment 3D model of the tooth of a quantitative feedback on the risk of perforation or the risk of fracture of the tooth root as a result of the post positioning; and
selecting or determining the optimal post and post position in order to reduce clinical risks or failure of the crown restoration, wherein this step develops a sequence of treatment steps for the preparation of the cavity and root canal for the post.
20. A non-transitory storage medium storing a computer program product which when executed on a computer causes the computer to perform a method for 3D planning of the restoration of a tooth comprising the steps of:
generating and visualizing a 3D model of the tooth to be restored by combining at least one piece of tooth specific digital information with a statistical, parameterized shape model of the relevant tooth type, wherein the 3D model includes the root canals and pulp chamber;
planning or simulating a root canal treatment on the generated 3D model of the tooth creating a post-treatment 3D model of the tooth;
allowing determining the dimensions of a core build-up to replace missing tooth material in the post-treatment 3D model in order to strengthen the tooth to prevent breakage;
creating a crown restoration on the post-treatment 3D tooth model by importing a wax-up or by selecting, positioning, and adapting a crown from a library of crowns in the post-treatment 3D model of the tooth, or by mirroring the existing contra-lateral crown of the patient, or by using a statistical model for fitting a crown in between the neighboring teeth of the tooth to be restored;
creating a visualization on the post-treatment 3D model of the tooth of a quantitative feedback of the available thickness of the remaining material of the tooth for the restorative crown and estimate the risk of fracture of the crown or possible crown perforations; and
selecting or determining an optimal core build-up and sequence of treatment steps for the crown restoration for ensuring tooth strength and successful crown restoration.