Method for dynamically guiding a dental oral and maxillofacial prosthesis using a 3d dataset

Abstract

An approach is disclosed that involves creating an implant-supported prosthesis that is dynamically guided into position using an image-guided navigation system into position in a patient’s mouth without the use of a surgical guide.

1 . A method for determining final locations of a set of implants relative to a three-dimensional dataset, the method comprising the steps of:
 a. providing a three-dimensional dataset including a planned location of the set of implants; a location of a set of implants surgically to be placed in a patient; and an actual location of a patient as provided by a patient tracker attached to the patient, wherein a transform relates the patient tracker to the three-dimensional dataset;   b. using a tracking system to measure the location of the set of implants simultaneously with the patient tracker; and   c. communicating a final location of the set of implants relative to the three-dimensional dataset.   
     
     
         2 . The method of  claim 1 , wherein providing the three-dimensional dataset includes obtaining the three-dimensional dataset from a three-dimensional radiograph. 
     
     
         3 . The method of  claim 2 , wherein the three-dimensional radiograph is a cone beam computed tomogram. 
     
     
         4 . The method of  claim 2 , wherein the three-dimensional radiograph is an intraoral scan. 
     
     
         5 . The method of  claim 1 , wherein providing the three-dimensional dataset includes accessing digital files representing the three-dimensional dataset by a navigation system. 
     
     
         6 . The method of  claim 5 , wherein using the tracking system includes registering digital datasets representative of the planned location of the set of implants, the location of the set of implants, and the actual location of the patient are then registered to each other within a common coordinate system. 
     
     
         7 . The method of  claim 6 , wherein registering the planned location of the set of implants, the location of the set of implants, and the actual location of the patient includes spatially aligning common features of each imagining modality using rigid-body transformation. 
     
     
         8 . The method of  claim 1 , further comprising determining the planned location of the set of implants. 
     
     
         9 . The method of  claim 8 , wherein determining the planned location of the set of implants includes outlining anatomical features of the patient. 
     
     
         10 . The method of  claim 9 , wherein determining the planned location of the set of implants includes determining a desired position and a desired angulation of the set of implants. 
     
     
         11 . The method of  claim 10 , wherein determining the planned location of the set of implants includes determining a hole size of for receiving the set of implants. 
     
     
         12 . The method of  claim 11 , wherein determining the hole size is calculated by using a formula defined as Do + 2 (Et + H x tan(Ea)). 
     
     
         13 . A method of dynamically tracking an implant procedure comprising:
 receiving by a tracking system a first digital data set representative of a three-dimensional radiograph obtained of a patient;   determining a planned implant location for a dental implant based on the first digital dataset;   attaching an implant tracking fiducial to the dental implant;   attaching a patient tracking fiducial to the patient;   positioning the tracking system relative to the patient; and   using the tracking system to measure a location of the implant tracking fiducial simultaneously with a location of the patient tracking fiducial; and   communicating the planned implant location relative to the location of the implant tracking fiducial.   
     
     
         14 . The method of  claim 13 , further comprising registering the implant tracking fiducial to the tracking system. 
     
     
         15 . The method of  claim 13 , wherein the implant tracking fiducial includes a plate with a printed pattern. 
     
     
         16 . The method of  claim 13 , further comprising forming holes in the dental implant. 
     
     
         17 . The method of  claim 16 , wherein forming holes in the dental implant includes determining a hole size by using a formula defined as Do + 2 (Et + H x tan(Ea)). 
     
     
         18 . The method of  claim 13 , further comprising projecting image coordinates of the planned implant location into the tracking system. 
     
     
         19 . The method of  claim 13 , further comprising using the planned implant location to cue the tracking system where to look for the implant tracking fiducial. 
     
     
         20 . The method of  claim 13 , wherein the implant tracking fiducial is a shape of a protruding portion of the dental implant.