Dental tool guides

Abstract

A method of dental registration, comprising, rigidly coupling a base element to a maxillofacial area; inserting an object comprising at least one of a tool and a tool guide into a mouth in said maxillofacial area; and determining a position of said object relative to said rigid element without a reference element outside of said mouth.

1 . A method of dental registration, comprising: 
 rigidly coupling a base element to a maxillofacial area;    inserting an object comprising at least one of a tool and a tool guide into a mouth in said maxillofacial area; and    determining a position of said object relative to said rigid element without a reference element outside of said mouth.    
   
   
       2 . A method according to  claim 1 , wherein said base element comprises a rigid element.  
   
   
       3 . A method according to  claim 1 , comprising acquiring a 3D radiological image of at least a part of said maxillofacial area.  
   
   
       4 . A method according to  claim 3 , comprising acquiring a non-volumetric image of at least a part of said dental area including at least a part of said base element.  
   
   
       5 . A method according to  claim 4 , comprising: 
 identifying at least one registration mark of said rigid element on said non-volumetric image; and    registering said image to said 3D image, thereby registering said registration mark to said area.    
   
   
       6 . A method according to  claim 1 , comprising: 
 acquiring a first image of at least a part of said maxillofacial area;    acquiring a non-volumetric image of least a part of said dental area including at least a part of said base element;    identifying at least one registration mark of said rigid element on said non-volumetric image; and    registering said image to said first image, thereby registering said registration mark to said area.    
   
   
       7 . A method according to  claim 6 , wherein said first image comprises a surface image obtained using a plurality of measurable pins which penetrate gum tissue to bone tissue.  
   
   
       8 . A method according to  claim 6 , wherein said non-volumetric image comprises a 2D transmission image.  
   
   
       9 . A method according to  claim 5 , wherein determining comprises setting a desired position, and comprising selecting a desired relative position.  
   
   
       10 . A method according to  claim 5 , wherein determining comprises measuring an existing position.  
   
   
       11 . A method according to  claim 10 , wherein determining comprises adjusting said object to a new position responsive to said measured position.  
   
   
       12 . A method according to  claim 5 , wherein determining comprises aiming said tool using said position, at said maxillofacial area.  
   
   
       13 . A method according to  claim 5 , wherein rigidly coupling comprises inserting at least one pin into gum tissue of said maxillofacial area.  
   
   
       14 . A method according to  claim 5 , wherein rigidly coupling comprises coupling using a clamp.  
   
   
       15 . A method according to  claim 5 , wherein rigidly coupling comprises releasing said base element to elastically engage said maxillofacial area.  
   
   
       16 . A method according to  claim 5 , wherein rigidly coupling comprises attaching using at least one screw.  
   
   
       17 . A method according to  claim 5 , wherein rigidly coupling comprises attaching to a single portion of said maxillofacial area.  
   
   
       18 . A method according to  claim 5 , wherein rigidly coupling comprises attaching said rigid element to be adjacent to at least 35% of a jawbone of said maxillofacial area.  
   
   
       19 . A method according to  claim 5 , wherein rigidly coupling comprises mounting on an unpeeled gum.  
   
   
       20 . A method according to  claim 5 , wherein rigidly coupling comprises mounting on a tooth.  
   
   
       21 . A method according to  claim 5 , wherein said base element is customized for a particular maxillofacial area.  
   
   
       22 . A method according to  claim 5 , wherein said base element is mass produced.  
   
   
       23 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises acquiring one or more 2D transmission X-ray image of at least part of said maxillofacial area.  
   
   
       24 . A method according to  claim 23 , comprising viewing at least one opaque portion of said base element to determine an allowed drilling depth in said maxillofacial area.  
   
   
       25 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises optically scanning a surface of at least part of said maxillofacial area.  
   
   
       26 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises reconstructing a surface geometry of at least part of said maxillofacial area.  
   
   
       27 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises optically imaging at least part of said maxillofacial area.  
   
   
       28 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises ultrasonically imaging at least part of said maxillofacial area.  
   
   
       29 . A method according to  claim 5 , wherein acquiring a non-volumetric image comprises contact measurement using a plurality of measured pins that penetrate gum tissue.  
   
   
       30 . A method according to  claim 12 , wherein aiming comprises adjusting one or more joints on said tool to achieve said aiming.  
   
   
       31 . A method according to  claim 12 , wherein said aiming comprises aiming at least 2 degrees of freedom of movement and orientation.  
   
   
       32 . A method according to  claim 12 , wherein said aiming comprises aiming at least 3 degrees of freedom of movement and orientation.  
   
   
       33 . A method according to  claim 12 , wherein said aiming comprises aiming at least 5 degrees of freedom of movement and orientation.  
   
   
       34 . A method according to  claim 12 , wherein said aiming comprises adjusting a depth of penetration of said tool.  
   
   
       35 . A method according to  claim 12 , wherein said aiming comprises planning a position and orientation of a tool path of said tool and adjusting at least one of said position and orientation according to said determining position.  
   
   
       36 . A method according to  claim 12 , comprising monitoring at least one of a position and orientation of said tool during said aiming.  
   
   
       37 . A method according to  claim 36 , wherein said monitoring comprises displaying.  
   
   
       38 . A method according to  claim 37 , wherein said displaying comprises displaying an expected result of using said tool.  
   
   
       39 . A method according to  claim 37 , wherein said displaying comprises displaying a current effect of said tool.  
   
   
       40 . A method according to  claim 37 , wherein said displaying comprises displaying on a radiological image.  
   
   
       41 . A method according to  claim 37 , wherein said displaying comprises updating said display at least once per minute.  
   
   
       42 . A method according to  claim 37 , wherein said displaying comprises updating said display at least once per second.  
   
   
       43 . A method according to  claim 37 , wherein said displaying comprises calculating an expected layout of a dental prosthesis on a bore formed using said tool; and displaying said expected layout with said monitored position.  
   
   
       44 . A method according to  claim 37 , wherein said displaying comprises displaying a plurality of planned bores at different locations simultaneously.  
   
   
       45 . A method according to  claim 5 , comprising calculating an expected layout of a dental prosthesis on a bore formed using said tool; and displaying said expected layout with said determined position.  
   
   
       46 . A method according to  claim 5 , wherein said object is already mounted on said base element during said rigidly coupling.  
   
   
       47 . A method according to  claim 5 , comprising rigidly attaching said object on said base element after said inserting.  
   
   
       48 . A method according to  claim 47 , wherein attaching comprises attaching to a predetermining place on said base element.  
   
   
       49 . A method according to  claim 47 , wherein attaching comprises attaching using an adhesive.  
   
   
       50 . A method according to  claim 47 , wherein attaching comprises attaching mechanically.  
   
   
       51 . A method according to  claim 5 , wherein said object comprises a dental soft tissue remover.  
   
   
       52 . A method according to  claim 5 , wherein said object comprises a needle.  
   
   
       53 . A method according to  claim 5 , wherein said object comprises a cutter.  
   
   
       54 . A method according to  claim 5 , wherein said object comprises a laser.  
   
   
       55 . A method according to  claim 5 , wherein determining a position comprises using a plurality of encoders embedded in said tool guide  
   
   
       56 . A method according to  claim 5 , wherein determining a position comprises using a plurality of encoders embedded in said base.  
   
   
       57 . A method according to  claim 56 , wherein said tool guide comprises a drill guide and comprising adjusting said drill guide to have a desired position and orientation.  
   
   
       58 . A method according to  claim 57 , comprising attaching said adjusted drill guide to a dental area.  
   
   
       59 . A method according to  claim 57 , comprising locking said adjusted drill guide to maintain its adjustment.  
   
   
       60 . A method according to  claim 12 , wherein said tool comprises a drill and comprising measuring a length of a drill burr of said drill.  
   
   
       61 . A method according to  claim 5 , wherein inserting an object comprises fabricating said object.  
   
   
       62 . A method according to  claim 61 , wherein fabricating comprises drilling a bore in said object.  
   
   
       63 . A dental tool guide base, comprising: 
 a structure adapted to be rigidly and removably attached to a gum-covered jaw;    at least one guide attachment point defined on said structure, which at least one guide attachment point is adapted to rigidly attach a tool guide section to said structure; and    at least one registration mark adapted to be identified relative to said structure.    
   
   
       64 . A base according to  claim 63 , wherein said structure is elastically distortable for said attaching.  
   
   
       65 . A base according to  claim 63 , wherein said structure comprises at least one attachment pin adapted for attaching to a gum covered jaw.  
   
   
       66 . A base according to  claim 63 , wherein said structure comprises at least one attachment screw adapted for attaching to a gum covered jaw.  
   
   
       67 . A base according to  claim 63 , wherein said structure is in the form of a stent.  
   
   
       68 . A base according to  claim 63 , wherein said structure is adapted to be attached to a small locality of said jaw.  
   
   
       69 . A base according to  claim 63 , wherein said structure is mass-produced.  
   
   
       70 . A base according to  claim 63 , wherein said registration mark is suitable for identification by optical surface scanning method.  
   
   
       71 . A base according to  claim 63 , wherein said registration mark is suitable for identification by an optical imaging method.  
   
   
       72 . A base according to  claim 63 , wherein said registration mark is suitable for identification by two-dimensional x-ray images.  
   
   
       73 . A base according to  claim 63 , wherein said registration mark is suitable for identification by ultra-sound imaging.  
   
   
       74 . A base according to  claim 63 , wherein said attachment point is a snap-locking attachment point.  
   
   
       75 . A base according to  claim 63 , wherein said registration mark and said guide attachment points are spatially separated.  
   
   
       76 . A base according to  claim 63 , wherein said registration mark and said guide attachment points are spatially overlapping.  
   
   
       77 . A base according to  claim 63 , wherein said structure comprises two opposing panels connected by at least one bridge element.  
   
   
       78 . A base according to  claim 77 , wherein said structure comprises two opposing panels connected by at least one bridge element.  
   
   
       79 . A base according to  claim 78 , wherein said bridge includes an aperture for guiding a drill bore therethrough.  
   
   
       80 . A base according to  claim 63 , wherein said guide attachment point is positioned to a side of said jaw when said structure is attached to a gum-covered jaw.  
   
   
       81 . A base according to  claim 63 , wherein said structure is adapted to be attached to at least one tooth.  
   
   
       82 . A base according to  claim 63 , wherein said structure is adapted to mount on a gum.  
   
   
       83 . A base according to  claim 63 , wherein said structure is substantially transparent to x-rays, except for said registration mark.  
   
   
       84 . A base according to  claim 77 , comprising a radio-opaque grid on at least one of said panels.  
   
   
       85 . A base according to  claim 77 , comprising: 
 a plurality of pins in at least one of said panels, said pins being adapted to pierce gum tissue but not bone; and at least one encoder which reads a position of at least one of said pins.    
   
   
       86 . A base according to  claim 63 , wherein said guide attachment point is adapted to hold a block of material.  
   
   
       87 . A base according to  claim 63 , comprising a solid block adapted for engagement by said guide attachment point.  
   
   
       88 . A dental tool guide, comprising: 
 (a) a base section adapted to be mechanically coupled to hard tissue;    (b) an adjustable guide section having a range of possible orientations in a vicinity of said base section; and    (c) at least one encoder adapted to fit in a human mouth and configured to electronically report an orientation of said guide section relative to said base section.    
   
   
       89 . A tool guide according to  claim 88 , wherein said guide section is mechanically coupled to said base section.  
   
   
       90 . A tool guide according to  claim 88 , wherein said guide section is mechanically decoupled from said base section.  
   
   
       91 . A guide according to  claim 88 , comprising circuitry which presents at least an indication of said orientation.  
   
   
       92 . A guide according to  claim 88 , comprising circuitry which transmits said report in a wireless manner.  
   
   
       93 . A guide according to  claim 88 , comprising circuitry which transmits said report in a wired manner.  
   
   
       94 . A guide according to  claim 88 , wherein said base is in the form of a surgical stent.  
   
   
       95 . A guide according to  claim 88 , wherein said base is in the form of a brace extending out of said mouth.  
   
   
       96 . A guide according to  claim 88 , wherein said guide section comprises at least one adjustable portion.  
   
   
       97 . A guide according to  claim 96 , wherein said adjustable portion is adapted to be locked.  
   
   
       98 . A guide according to  claim 97 , wherein said locking comprises mechanical locking.  
   
   
       99 . A guide according to  claim 97 , wherein said locking comprises locking by application of heat.  
   
   
       100 . A guide according to  claim 88 , wherein said guide is opaque to x-ray radiation.  
   
   
       101 . A guide according to  claim 88 , wherein said guide is transparent to x-ray radiation.  
   
   
       102 . A guide according to  claim 88 , wherein said guide comprises at least one radio-opaque marking.  
   
   
       103 . A guide according to  claim 88 , wherein said encoder comprises an optical encoder.  
   
   
       104 . A guide according to  claim 88 , wherein at least one of said at least one encoder is mounted on said base.  
   
   
       105 . A guide according to  claim 88 , wherein at least one of said at least one encoder is mounted on said guide.  
   
   
       106 . A guide according to  claim 88 , wherein at least one of said at least one encoder comprises at least two sensing parts, a sensed part and a sensing part, each one of said parts mounted on a different one of said guide and said base.  
   
   
       107 . A guide according to  claim 88 , wherein said base is customized to patient's jaw or teeth  
   
   
       108 . A guide according to  claim 88 , wherein said base includes a registration mark.  
   
   
       109 . A guide according to  claim 88 , wherein said guide section is in the form of an arm.  
   
   
       110 . A guide according to  claim 109 , wherein said arm has at least 3 degrees of freedom relative to said base.  
   
   
       111 . A guide according to  claim 109 , wherein said guide section comprises: 
 a plurality of joints which adjust said drill guide section relative to said base; and    a plurality of encoders which directly measure orientation of said joints.    
   
   
       112 . A guide according to  claim 111 , wherein said joints are orthogonal to each other.  
   
   
       113 . A guide according to  claim 88 , comprising a drilling depth adjuster.  
   
   
       114 . A dental tool guide aiming-device, comprising: 
 a base adapted to fixedly engage an adjustable tool guide;    a guide holder adapted to engage a guiding section of said tool guide;    at least one control adapted to move said guide holder and thereby change the orientations of one or more joints of said drill guide.    
   
   
       115 . An aiming device according to  claim 114 , wherein said guide holder comprises a peg.  
   
   
       116 . An aiming device according to  claim 114 , wherein said guide holder prevents translation of said guide.  
   
   
       117 . An aiming device according to  claim 114 , wherein said control comprises a manual control.  
   
   
       118 . An aiming device according to  claim 114 , wherein said control comprises a motor.  
   
   
       119 . An aiming device according to  claim 114 , comprising a controlling attachment to a computer.  
   
   
       120 . An aiming device according to  claim 119 , wherein said computer includes a display adapted to display an effect of said adjustment.  
   
   
       121 . A aiming device according to  claim 114 , comprising a drill depth adjuster.  
   
   
       122 . An aiming device according to  claim 121 , comprising a set of replaceable depth adjusters for different depths.  
   
   
       123 . An aiming device according to  claim 114 , comprising a set of sleeves for varying an outer diameter of said peg.  
   
   
       124 . An aiming device according to  claim 114 , comprising a drill length measuring element.  
   
   
       125 . A dental tool guide, comprising: 
 (a) a base section adapted to be mechanically coupled to hard tissue;    (b) an adjustable guide section having a range of possible orientations in a vicinity of said base section; and    (c) a lock which selectively mechanically locks said guide section to prevent further adjustment.    
   
   
       126 . A guide according to  claim 125 , wherein said base is in the form of a surgical stent.  
   
   
       127 . A guide according to  claim 125 , wherein said base is in the form of a brace extending out of said mouth.  
   
   
       128 . A guide according to  claim 125 , wherein said guide section comprises at least one adjustable portion.  
   
   
       129 . A guide according to  claim 125 , wherein said locking comprises mechanical locking.  
   
   
       130 . A guide according to  claim 129 , wherein said locking comprises tightening of a screw.  
   
   
       131 . A guide according to  claim 125 , wherein said locking comprises locking by application of heat.  
   
   
       132 . A guide according to  claim 125 , wherein said guide is opaque to x-ray radiation.  
   
   
       133 . A guide according to  claim 125 , wherein said guide is transparent to x-ray radiation.  
   
   
       134 . A guide according to  claim 125 , wherein said guide comprises at least one radio-opaque marking.  
   
   
       135 . A guide according to  claim 125 , wherein said base is customized to a patient's jaw or teeth.  
   
   
       136 . A guide according to  claim 125 , wherein said base includes a registration mark.  
   
   
       137 . A guide according to  claim 125 , wherein said guide section is in the form of an arm.  
   
   
       138 . A guide according to  claim 137 , wherein said arm has at least 3 degrees of freedom relative to said base.  
   
   
       139 . A guide according to  claim 137 , wherein said guide section comprises a plurality of joints which adjust said drill guide section relative to said base.  
   
   
       140 . A guide according to  claim 139 , wherein said joints are orthogonal to each other.  
   
   
       141 . A guide according to  claim 125 , comprising a drilling depth adjuster.  
   
   
       142 . A guide according to  claim 125 , wherein said guide section is permanently attached to said base.  
   
   
       143 . A guide according to  claim 125 , wherein said guide section is selectively attachable to said base.