FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to dentistry, and is intended for use in the manufacture of orthopedic structures based on implants in the prosthetics of patients with complete loss of teeth. Impressions are made from the alveolar processes of the upper and lower jaws, according to which plaster diagnostic models of the jaws are made, from which virtual diagnostic models of the jaws are obtained. Then, on virtual diagnostic models of the lower and upper jaws, respectively, virtual radiological templates are modeled based on the occlusal surface of the mucous membrane of the crest of the corresponding alveolar processes, while marker recesses are made in the virtual radiological templates. Then, according to the models of virtual radiological templates, physical radiological templates are made by 3D printing, in which radiopaque material is placed in the marker recesses, after which the physical radiological templates are applied to the patient on the crests of the corresponding alveolar processes and a computed tomogram of the upper and lower jaws is performed in the usual occlusion with the capture of structures temporomandibular joints. Then, in the Avantis3D program, the virtual diagnostic models of the jaws with the virtual radiological templates modeled on them are compared with the obtained computed tomogram, while the images of the marker recesses on the virtual radiological templates are combined with the corresponding radiopaque markers on the corresponding alveolar processes of the computed tomogram, after which the images of the virtual radiological templates are removed. Then the virtual lower jaw is set in the optimal position, namely: using the Avantis3D computer program, the central ratio of the jaws is determined by virtual changing the position of the heads of the virtual lower jaw relative to the mandibular fossae of the temporal bone of the virtual temporomandibular joint, respectively, positioning the lower jaw until the width of the joint space is normalized and fixation parameters of the joint space taken as the norm, after which, in the obtained optimal position of the virtual lower jaw, virtual implantological templates are modeled for the upper and lower jaws based on the mucous membrane along the entire arc of the corresponding crests of the alveolar processes of the virtual diagnostic models of the upper and lower jaws and a virtual bite occlusal roller with support on the mucous membrane along the entire arc of the corresponding crests of the alveolar processes of virtual diagnostic models of the upper and lower jaws. Then, according to the virtual digital models obtained in the optimal position of the lower jaw, physical models of implant templates and a physical model of the bite occlusal ridge are made by 3D printing, which are used, respectively, for installing implants and for making fixed restorations of the teeth of the upper and lower jaws based on implants.
EFFECT: method, due to the use of digital modeling and the use of implant templates made in the optimal position of the jaw, allows to increase the accuracy of setting the lower jaw in the optimal position in the absence of teeth, to ensure physiological occlusion, to evenly distribute masticatory loads along the alveolar arch and reduce the occurrence of TMJ dysfunction, and also exclude the influence of the subjective factor.
3 cl, 25 dwg, 1 ex
