T-scan系统结合数字化模型测量咬合力分布的可靠性和准确性研究  

Repeatability and validity of a modified method of measuring the occlusal force distribution with the T-scan system and digital models

作　　者：黄墁珊 寻春雷[1] Huang Manshan;Xun Chunlei(Department of Orthodontics,Peking University School and Hospital of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Naterial Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院正畸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重点实验室,北京100081

出　　处：《中华口腔正畸学杂志》2020年第2期90-95,共6页Chinese Journal of Orthodontics

摘　　要：目的检测一种利用牙冠宽度和虚拟模型咬合接触信息区分T-Scan咬合接触图牙位分区方法的准确性和可重复性。方法招募20名正畸治疗后患者,分别制取牙列石膏模型和用T-scanⅢ咬合分析仪记录牙尖交错位的咬合,方法1:用游标卡尺测量模型的牙冠宽度,按照冠宽设置T-scan结果图的牙位分区;方法2:受试者接受咬合纸检查并拍摄上牙弓[牙合]面照片,以冠宽为基础,结合咬合纸印记设置牙位分区;方法3:进行模型扫描,数据导入Geomagic软件测量0.4 mm颌间距离内的接触区,以冠宽为基础,结合虚拟接触区设置牙位分区。统计每一种方法各个牙位的咬合力百分比,重复测量3次。用组内相关系数(intraclass correlation coefficient,ICC)分析重复测量的一致性,记录方法1中接触区超出牙弓远中界的比例,以方法2的结果作为真实参考,用Friedman检验分析三种方法测量结果的差异性并两两比较。结果三种设置T-scan牙位分区的方法均有很高的重复测量信度(ICC>0.9),方法1中65%的T-scan接触区超出牙弓,方法1的测量结果与方法2、3存在差异(P<0.001),方法2与方法3无统计学差异。结论依据冠宽和虚拟接触区进行T-scan牙位划分是一种较准确、可重复性很高的方法,仅依据冠宽区分T-scan牙位的方法准确性不佳。Objective To test the repeatability and validity of a modified method that differentiated the occlusal contacts on the T-scan image of each teeth with information of the tooth width and the virtual occlusal contact area.Methods Twenty young adults who had finished orthodontics treatment were recruited to make plaster dental casts and their interdigitated position were recorded by T-scanⅢ.In group A,vernier caliper measures the crown widths,and use it to set the result zones from T-Scan.In group B,articulating paper occlusion records and upper occlusal photos were used to set the zone areas based on crown widths.In group C,digital models were obtained by scanning the plaster model,and then imported to Geomagic software to detect the contact points within 0.4 mm intermaxillary distance,andthe Zone is determined based on contacts and crown width.The relative force of each molar,premolar and the anterior section was recorded.This procedure was repeated 3 times and repeatability was tested using intraclass correlation coefficient(ICC).In group A,the percentage of contact markings that went beyond the distal boundary of the maxillary second molar was calculated.Friedman test and post hoc test were used to compare three groups and validity was assessed with group B as the standard.Results All the three methods showed high reliability(ICC>0.9).In group A,contact markings in the T-scan images crossed the distal boundary of 65%second molars.The occlusal force distribution in group A was different from that of group B and C(P<0.001),while no significant difference was found between group B and C.Conclusions It is a reliable and accurate method to measure the occlusal force distribution when using T-scan according to tooth width and virtual contact area.But the method that merely refers to tooth width is inaccurate.

关 键 词：T-scan 数字化模型 咬合力分布 咬合接触 

分 类 号：R783.5[医药卫生—口腔医学]