无牙颌印模用个别托盘椅旁计算机辅助设计和三维打印系统建立与临床初步评价  

Establishment and preliminary clinical evaluation of edentulous custom trays designed and fabricated by chair-side CAD and 3D printing systems

作　　者：王冠博 叶红强[1] 陈虎[2] 王勇[2] 孙玉春[2] 周永胜[1] WANG Kuan-paul;YE Hong-qiang;CHEN Hu;WANG Yong;SUN Yu-chun;ZHOU Yong-sheng(Department of Prosthodontics,Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Center of Digital Dentistry,Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology,Research Center of Engineering and Technology for Digital Dentistry,Ministry of Health,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院.口腔医院修复科国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,北京100081 [2]北京大学口腔医学院.口腔医院口腔医学数字化研究中心国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室卫生部口腔医学计算机应用工程技术研究中心,北京100081

出　　处：《北京大学学报（医学版）》2019年第2期349-355,共7页Journal of Peking University:Health Sciences

基　　金：首都卫生发展科研专项(2016-1-4101);科技北京百名领军人才培养工程(Z171100001117169)~~

摘　　要：目的:采用自主研发的无牙颌个别托盘椅旁数字化系统设计并三维打印无牙颌个别托盘,用视觉模拟评分法,基于医师对该个别托盘制取终印模的满意度,初步评价其临床应用效果。方法:由三位经过统一操作流程培训的修复医师随机接诊于北京大学口腔医院就诊的15名上、下颌牙列缺失患者,分别采用自主研发无牙颌个别托盘椅旁数字化系统和传统手工法制作无牙颌个别托盘,高流动型硅橡胶印模材制取终印模。采用视觉模拟评分法设计调查问卷,由制取终印模的三位医师根据制取印模的满意程度填写调查问卷,进行满意度调查。结果:根据制取印模的满意程度,使用自主研发无牙颌个别托盘椅旁数字化系统制作的个别托盘与传统手工法制作的无牙颌个别托盘在口腔内试戴(整体尺寸、外形、是否利于握持等)的平均满意度分别为9.18±0.19和8.23±0.22,两者差异有统计学意义(P<0.05);试戴时边缘位置(边缘伸展、系带切迹)的平均满意度分别为8.91±0.40和7.96±0.23,两者差异有统计学意义(P<0.05);托盘稳定性的平均满意度分别为8.80±0.83和8.01±0.81,两者差异有统计学意义(P<0.05);终印模制取效果(完整性、印模材厚度、是否漏出托盘、边缘形态)的平均满意度分别为8.94±0.68和7.99±0.42,两者差异有统计学意义(P<0.05);优质终印模获取难度(重复次数、效率)的平均满意度分别为9.20±0.37和7.88±0.22,两者差异有统计学意义(P<0.05);整体的平均满意度分别为9.11±0.49和7.95±0.15,两者差异有统计学意义(P<0.05)。结论:使用自主研发无牙颌个别托盘椅旁数字化系统制作的个别托盘制取终印模的医师满意度高于传统手工光固化法制作的个别托盘,达到临床要求,可进一步在临床上推广使用。Objective: To design and fabricate edentulous custom trays by chair-side computer-aided design and 3-dimensional printing (CAD/3DP) system of independent research and development and to evaluate their clinical effects based on prosthodontists ’ satisfaction using the visual analogue scale (VAS). Methods: Fifteen edentulous patients were randomly recruited by three prosthodontists who passed the unified operating process training. The custom trays for each patient were fabricated using both chair-side CAD/3DP system of independent development and manually conventional method, and the final impressions were made by silicone impression materials (light body). The prosthodontist’s satisfaction was surveyed by the three prosthodontists via the questionnaire based on visual analogue scales. Results: In the degree of the prosthodontist’s satisfaction of final impressions, the average satisfactions of “try in”(the overall size, shape, convenience, etc .) on the 3DP custom tray made by independent development chair-side system and the manually conventional method were 9.18±0.19 and 8.23±0.22, respectively. The average satisfactions of the border line position (border extensions, frenal notch)were 8.91±0.40 and 7.96±0.23, respectively. The average satisfactions of the stability in border molding were 8.80±0.83 and 8.01±0.81, respectively. The average satisfactions of the quality of final impression (completeness, thickness of impression material, exposure of custom tray, shape of border) were 8.94±0.68 and 7.99±0.42, respectively. The average satisfactions of the difficulty of high quality impression (times of repetition, efficiency) were 9.20±0.37 and 7.88±0.22, respectively. The average satisfactions of the overall satisfaction were 9.11±0.49 and 7.95±0.15, respectively. There was signi- ficant difference in the satisfaction of “try in”, border line position, stability in border molding, quality of final impression, difficulty of high quality impression, and overall satisfaction between the 3DP

关 键 词：义齿 全口 计算机辅助设计 打印 三维 个别托盘 

分 类 号：R783.6[医药卫生—口腔医学]