口内扫描数字化模型检测[牙合]接触准确率的临床研究  

Clinical study on the accuracy of occlusal contacts on digital model

作　　者：刘洪良 刘星纲[1] 田月明[1,4] 倪琳[2] 郑东翔 Liu Hongliang;Liu Xinggang;Tian Yueming;Ni Lin;Zheng Dongxiang(Department of Prosthodontics,Capital Medical University School of Stomatology,Beijing 100050,China;Medical Research&Biometrics Center,National Center for Cardiovascular Diseases,Beijing 100037,China)

机构地区：[1]首都医科大学口腔医学院修复科,100050 [2]国家心血管病中心医学统计部,北京100037 [3]北京市普仁医院口腔科,100062 [4]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,100081 [5]首都医科大学附属北京佑安医院,100069

出　　处：《中华口腔医学杂志》2020年第10期737-742,共6页Chinese Journal of Stomatology

基　　金：北京市医院管理局重点医学专业发展计划(ZYLX201828);北京市属医院科研培育计划(PX2017031)。

摘　　要：目的研究口内扫描数字化模型检测[牙合]接触的准确率,为数字化咬合分析和设计提供参考。方法选择牙列完整的首都医科大学口腔医学院在读研究生志愿者20名,其中男性6名,女性14名,年龄(24.4±1.4)岁,研究区域为左侧半口牙列。采用诊断试验研究设计,以硅橡胶透光法提取的最大牙尖交错位(maximal intercuspal position,MIP)[牙合]接触点为参照标准,提取界值设定为≤50μm。使用口内扫描仪扫描开口状态下上下颌左侧半口牙列,并扫描MIP状态下左侧牙列颊侧;选择MIP颊侧扫描图像不同位置,设置5种配准方法:1-3牙位法(中切牙至尖牙)、3-6牙位法(尖牙至第一磨牙)、4-6牙位法(第一前磨牙至第一磨牙)、5-6牙位法(第二前磨牙至第一磨牙)、1-6牙位法(中切牙至第一磨牙),将开口状态下上下颌左侧半口牙列数据配准生成5种数字化模型的[牙合]接触图像。将左侧上颌半口牙列面分为28个分区,计算数字化模型检测[牙合]接触的准确率;并进行前牙区、前磨牙区、磨牙区的亚组分析。结果5种数字化模型检测[牙合]接触的准确率分别为:1-3牙位法86.8%、3-6牙位法92.0%、4-6牙位法90.7%、5-6牙位法91.1%、1-6牙位法90.4%,其中1-3牙位法的准确率显著小于其他4种方法(P<0.05),其余各法两两比较的差异均无统计学意义(P>0.05)。亚组分析显示,5种数字化模型检测前牙区、前磨牙区和磨牙区[牙合]接触的准确率分别为86.7%~92.8%、92.5%~94.4%、77.3%~93.6%,磨牙区1-3牙位法的准确率显著小于5-6牙位法(P<0.05),1-3牙位法检测磨牙区的准确率显著小于前牙区和前磨牙区(P<0.05),其余两两比较差异均无统计学意义(P>0.05)。结论口内扫描获得的数字化模型检测[牙合]接触的准确率较高.Objective To explore the accuracy of occlusal contacts on digital model made by intraoral scanner.Methods Twenty healthy subjects[6 males,14 females,(24.4±1.4)years old]with intact dentition were randomly recruited from postgraduate students in Capital Medical University School of Stomatology who volunteered to participate in this study.For each participant,the 2nd and 3rd quadrant of natural dentition was scanned.A diagnostic test design was performed.The occlusal contacts of the maximal intercuspal position(MIP)were extracted with the transillumination of silicone interocclusal records,and the extraction threshold was set as≤50μm.Intraoral scanning system was used to scan in MIP and generate occlusal contacts on digital model.Five groups were designed as test groups according to included tooth position:group 1(buccal scanning ranged from tooth 21 to 23),group 2(buccal scanning ranged from tooth 23 to 26),group 3(buccal scanning ranged from tooth 24 to 26),group 4(buccal scanning ranged from tooth 25 to 26),group 5(buccal scanning ranged from tooth 21 to 26).Five groups occlusal contacts on digital model were generated respectively.According to the relevant literature,the upper occlusal surface was divided into 28 partitions,and the accuracy of occlusal contacts on digital model was calculated with the transillumination of silicone interocclusal records as the reference standard.Subgroup analysis was performed according to anterior teeth area,premolars area and molars area.Results The accuracy of occlusal contacts on digital models of the half dentition in five buccal scanning positions were:group 1(86.8%),group 2(92.0%),group 3(90.7%),group 4(91.1%),group 5(90.4%),and the accuracy of occlusal contacts in group 1 was significantly lower than those in the other four groups(P<0.05).The accuracy of anterior teeth area were 85.6%-93.9%;the accuracy of premolar area were 92.5%-94.4%;the accuracy of molar area were 77.3%-93.6%,group 1 was significantly lower than those in the group 4 in molars area(P<0.05),the acc

关 键 词：牙 牙模型 口内扫描 接触 

分 类 号：R783[医药卫生—口腔医学]