Method and system for comprehensive evaluation of orthodontic care using unified workstation

• US 20050271996A1
• Filed: 05/20/2005
• Published: 12/08/2005
• Est. Priority Date: 04/13/2001
• Status: Active Grant

• Current Assignee: Orametrix Incorporated
• Original Assignee: Orametrix Incorporated
• Inventors: Kaufmann, Markus, Sporbert, Peer, Sachdeva, Rohit, Strauss, Claudia, Roberts, Doke Evan
• Granted Patent: US 8,021,147 B2
• Time in Patent Office: Days
• US Class Current: 433/24
• CPC Class Codes: A61C 2007/004 Automatic construction of a set of axes for a tooth or a plurality of teeth
• CPC Class Codes: A61C 7/00 Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
• CPC Class Codes: A61C 7/002 Orthodontic computer assisted systems
• CPC Class Codes: A61C 7/146 Positioning or placement of brackets; Tools therefor
• CPC Class Codes: A61C 9/0046 Data acquisition means or methods

Abstract

A method and system for orthodontic treatment planning, evaluation and quality measurement is provided comprising a workstation having computing platform, a graphical user interface, a processor and a computer storage medium containing digitized records pertaining to a patient. The digitized records include image and other types of data. The computer storage medium further includes a set of software instructions providing graphical user interface tools for providing a user with access to the digitized records for planning orthodontic treatment of a patient. Also provided are reference databases for aiding in the decision process during treatment selection, treatment planning and treatment delivery and progress monitoring and evaluation. Also provided are parameter or criteria measurement techniques and generally acceptable thresholds, which can be updated through learning process and through acquisition of patient data. Once the treatment is planned, the virtual dentition model of the patient in the proposed treatment set-up or the target state is evaluated using several virtual model evaluation features and criteria.

Claims

1. A system for comprehensive treatment planning, evaluation and measurement of quality of care of an orthodontic patient comprising:

a workstation having a computing platform comprising a graphical user interface, a processor and a computer storage medium; and

a set of one or more reference databases accessible to said workstation;

wherein said computer storage medium contains digitized records pertaining to a patient, said digitized records including image data, text data, and a three-dimensional virtual model of said patient wherein said virtual model includes a three dimensional dentition model of said patient;

wherein said computer storage further contains a set of software instructions for planning and evaluating orthodontic treatment of said patient;

wherein said computer storage further includes software instructions providing graphical user interface tools for providing a user with access to said digitized records for planning and evaluating orthodontic treatment of said patient;

wherein said set of software instructions include instructions for evaluating at least one of the following criteria pertaining to orthodontic treatment;

a) treatment efficiency criterion;

b) treatment effectiveness criterion;

c) patient connectedness to treatment criterion;

d) treatment timeliness criterion;

e) treatment safety criterion; and

f) treatment equitability criterion.

2. The system of claim 1, wherein said treatment efficiency criterion comprises at least one of the following sub-criteria (i) productivity of the people delivering the treatment, (ii) cost and availability of materials required for the treatment, (iii) suitability of the treatment method for the patient, and the estimated time duration for the treatment, (iv) reliability and cost contributions towards the treatment of the patient from the equipment necessary for creating and delivering the treatment, and (v) the cost contribution and other criteria attributable to the environment in which the treatment is delivered.

3. The system of claim 1, wherein said treatment effectiveness criterion comprises at least one of the following sub-criteria:

(i) alignment, (ii) marginal ridges, (iii) buccolingual inclination, (iv) occlusal relationship, (v) cclusal contacts, (vi) overjet, (vii) interproximal contacts, (viii) vertical alignment of buccal cusp tips, (ix) vertical alignment of front, and (x) angulation of front.

4. The system of claim 1, wherein said patient connectedness to treatment criterion comprises at least one of the following sub-criteria:

(i) matching treatment results with the patient expectations, (ii) care of service, (iii) patient comfort, and (iv) patient overall satisfaction.

5. The system of claim 1, wherein said treatment timeliness criterion comprises at least one of the following sub-criteria:

(i) appointment intervals, (ii) length of appointments, (iii) (iv) time spent waiting in the reception area, and (v) difference between the estimated treatment time and the actual treatment time.

6. The system of claim 1, wherein said treatment safety criterion comprises at least one of the following sub-criteria:

(i) the number of episodes causing discomfort or pain to the patient, (ii) the nature of pain, (iii) decalcification of teeth, (iv) root resorption, (v) gingivitis, (vi) periodontitis, (vii) iatrogenic event where the problem is caused by the practitioner'"'"'s mistake, (viii) idiopathic event where there is no known cause for the problem;

however the patient is sensitive to the treatment; and

(ix) idiosyncratic event which develops a new response within the patient which was never recorded before in the history of the treatment.

7. The system of claim 1, wherein said treatment equitability criterion comprises at least one of the following sub-criteria:

(i) whether or not same standard of care is offered to all patients, and (ii) matching of patient profile against the treatment needs of the patient, against established clinical pathways, and between offerings from different orthodontic practices.

8. The system of claim 1, wherein said reference databases include a normative database.

9. The system of claim 8, wherein said normative database enables said user to compare an initial dentition state and a treatment set-up state against normative data.

10. The system of claim 1, wherein said digitized records further comprise a library of virtual bracket sets enabling said user in evaluating a prescription for said treatment set-up state and said evaluation tools enabling said practitioner to make adjustments to said prescription by choosing an appropriate bracket from said library and/or changing the position of said bracket relative to a tooth.

11. The system of claim 1, wherein said evaluation tools enable comparisons of tooth positions in said patient'"'"'s initial state relative to tooth positions in the proposed treatment set-up state.

12. The system of claim 11, wherein said comparisons of tooth positions are done by viewing said intial state and said proposed treatment set-up side-by-side.

13. The system of claim 11, wherein said comparisons are done by superimposition of said states and providing visual indicia of the change of position from said initial state and said proposed treatment set-up state.

14. The system of claim 11, wherein said comparisons of tooth positions are done automatically.

15. A computerized method of planning treatment for an orthodontic patient, comprising the steps of:

providing an orthodontic treatment planning workstation comprising a computing platform having a graphical user interface, a processor and a computer storage medium containing digitized records pertaining to a patient, said digitized records including image data, and a set of software instructions providing graphical user interface tools for providing a user with access to said digitized records and for planning orthodontic treatment of a patient;

selecting a treatment plan;

generating a proposed set-up for treating the patient in accordance with said selected treatment plan, the proposed set-up comprising a proposed three-dimensional position of the dentition of the patient in a post-treatment condition;

conducting an evaluation of said proposed set-up, said evaluation prompted by computer instructions providing a series of predetermined steps for guiding a user to interactively evaluate said proposed set-up, wherein the predetermined steps comprise steps for checking (a) vertical alignment of buccal cusp tips;

(b) vertical alignment of front, and (c) checking angulation of front;

monitoring progress of said treatment; and

evaluating said progress of said treatment.

16. The method of claim 15, wherein said proposed set-up is transmitted over a communications medium to a remote workstation, said remote workstation comprising said computer instructions providing said series of predetermined steps for guiding a user to interactively evaluate said proposed set-up.

17. The method of claim 15, wherein the computer instructions further comprise instructions which allow a user to modify the proposed set-up during one or more of said predetermined steps, and wherein modifications made in any one of said one or more predetermined steps are carried over to subsequent steps in said series of predetermined steps.

18. The method of claim 15, wherein the computer instructions further comprise instructions which allow a user to navigate through said series of predetermined steps in any order desired by the user.

19. The method of claim 15, wherein said series of predetermined steps further comprise the following evaluation steps of the proposed set-up:

1. checking alignment,

2. checking marginal ridges;

3. checking buccolingual inclination;

4. checking occlusal relationship;

5. checking occlusal contacts;

6. checking overjet; and

7. checking interproximal contacts.

20. The method of claim 19, wherein said computer instructions are designed to guide a user to follow steps 1-7 in numerical order, while simultaneously providing the user to navigate from any one of said steps to any other of said steps.

21. The method of claim 15, wherein said digitized records further comprise a normative database.

22. The method of claims 21, further comprising the step of comparing said initial state and said treatment set-up state against said normative data.

23. A method for orthodontic treatment evaluation for a patient facilitated by a treatment planning workstation comprising a computing platform having a graphical user interface, a processor and a computer storage medium comprising the steps of:

(a) storing in said computer storage medium digitized records pertaining to the patient including image data including 2d and 3D radiographic data, photographic and 3D data sets comprising virtual models of the patient'"'"'s dentition in an initial state and a treatment set-up state;

(b) providing in said computer storage a set of software instructions for graphical user interface tools for access to said digitized records for treatment set-up evaluation of said patient, and a set of computer instructions providing a set of treatment evaluation tools for a user;

(c) with the aid of said evaluation tools, evaluating said patient'"'"'s treatment set-up by performing the following steps;

1. checking alignment,

2. checking marginal ridges;

3. checking buccolingual inclination;

4. checking occlusal relationship;

5. checking occlusal contacts;

6. checking overjet;

7. checking interproximal contacts;

8. checking vertical alignment of buccal cusp tips;

9. checking vertical alignment of front, and

10. checking angulation of front;

wherein steps (1)-(10) are done in the order listed above or in any other order selected by said user, and repeated as deemed necessary by said user and wherein steps (1)-(10) further include making comparisons and making modifications in the treatment set-up as and when necessary; and

(d) accepting said treatment set-up when results in steps (1)-(10) are acceptable;

otherwise rejecting said treatment set-up.

24. The method of claim 23, further comprising the step of comparing said states against digital records for the patient, said records comprising at least one of scan data, dentition model, intra-oral photographs and x-rays.

25. The method of claim 24, further comprising comparing said states against a dentition model derived from a physical model of the patient'"'"'s dentition.

26. The method of claim 23, further comprising the steps of evaluating individual virtual teeth in at least one of the virtual models of the patient'"'"'s dentition from a morphometric perspective and providing tools by which changes in the shape of the teeth may be simulated.

27. The method of claim 23, further comprising providing interactive and communications features in said workstation wherein one or more specialists may remotely examine said patient'"'"'s records and conduct a remote evaluation of said treatment set-up state.

28. The method of claim 23,wherein said patient'"'"'s digitized records further include said patient'"'"'s pre-processed dentition data and further comprising the steps comparing said patient'"'"'s pre-processed dentition data with said patient'"'"'s post-processed data.

29. The method of claim 23, wherein said step of comparing comprises comparing the measured value against a threshold value.

30. The method of claim 29, wherein said threshold value is set by the user.