CAD/CAM-gestützte Planung und Übertragungsmöglichkeiten von Brackets und Gaumenimplantaten

Zusammenfassung

In der Kieferorthopädie kommen digitale Technologien zunehmend zum Einsatz. Während zunächst einzelne Arbeitsschritte, wie die Patientenverwaltung oder kieferorthopädische Diagnostik digital durchgeführt wurden, gibt es inzwischen einen Trend hin zu einem vollständig digitalisierten Workflow. Während digitale Technologien häufig die Stuhlzeit verkürzen, kann die digitale Vorbereitungszeit am Computer länger sein. Durch moderne Softwarelösungen lassen sich allerdings auch diese Arbeitsschritte effizient gestalten: Mithilfe entsprechender Software lässt sich bspw. die gewünschte Position der Brackets inklusive einer Übertragungsschablone im Rahmen der Multibracket-Behandlung vorab virtuell planen. Die Schablone kann im Anschluss mittels additiver Fertigungsverfahren (3D-Druck) in einem Labor oder in der Zahnarztpraxis hergestellt werden. Auch für eine skelettale Verankerung kann ähnlich zur zahnärztlichen Implantologie die Insertionsposition digital geplant und über Insertionsschablonen in den Patientenmund übertagen werden. Durch eine Überlagerung von DVT- oder FRS-Daten mit einem digitalen Modell kann die Position hinsichtlich des individuellen Knochenangebots optimiert werden.

Das Ziel dieses Artikels ist es, einen Überblick über die Möglichkeiten der Bracket- und Mini-Implantat-Planung sowie Möglichkeiten zur Übertragung der virtuellen Planung in den Mund des Patienten klinisch vorzustellen und diese im Zusammenhang mit aktueller Literatur zu diskutieren.

Abstract

Digital technologies are increasingly employed in orthodontics. Whereas only parts of the orthodontic workflow were carried out digitally at the beginning, e. g. patient administration or diagnostics, there is now a trend towards a completely digitalized workflow. While reduced chair time is associated with the digital workflow, preparation time at the computer can be higher. However, modern software solutions significantly improve efficiency. With the help of software tools, the desired position of the brackets, including a transfer template, can be virtually planned on the computer as part of the multibracket treatment. The template will then be produced in a laboratory or in the dental practice using additive manufacturing processes (3D printing). Similar to implant dentistry, the insertion position for skeletal anchorage devices can be digitally planned and transferred to the patient’s mouth through insertion guides. By superimposing CBCT or lateral cephalograms with a digital model, the localization of the implants can be optimized with regard to the individual bone supply.

The aim of this article is to present a clinical overview of the possibilities of bracket and orthodontic mini-implant planning with a digital model as well as possibilities for transferring the virtual planning into the patient's mouth and to discuss them considering recent literature.

Schlüsselwörter

Bracket-Position - Gaumenimplantat - CAD/CAM - Digitaler Workflow - 3D-Druck

Key words

Bracket position - palatal miniscrew - CAD/CAM - digital workflow - 3D printing

Publication History

Article published online:
11 September 2020

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