上下颌牙列缺失应用数字化技术制作复制义齿修复一例  

Fabrication of duplicate dentures using digital technique for an edentulous patient:A case report

作　　者：王兵[1] 国丹妮 衡墨笛 国丽丽 周永胜[2] 潘韶霞[2] Wang Bing;Guo Danni;Heng Modi;Guo Lili;Zhou Yongsheng;Pan Shaoxia(Dental Laboratory,Peking University School and Hospital of Stomatology,Beijing 100081,China;Department of Prosthodontics,Peking University School and Hospital of Stomatology&National Center 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 Computerized Dentistry Ministry of Health&NMPA Key Laboratory for Dental Materials,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院义齿加工中心,100081 [2]北京大学口腔医学院·口腔医院修复科,国家口腔医学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国家卫生健康委口腔医学计算机应用工程技术研究中心,100081

出　　处：《中华口腔医学研究杂志（电子版）》2021年第4期234-240,共7页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：国家重点研发计划子课题(2020YFC2009005⁃02);北京大学口腔医学院临床新技术新疗法重点项目(PKUSSNCT⁃20G03);北京大学口腔医学院临床新技术新疗法普通项目(PKUSSNCT⁃19B03)。

摘　　要：目的报道1例应用数字化技术制作上下颌复制义齿病例,探讨数字化复制义齿制作流程及临床应用效果。方法患者,女,54岁,2020年8月就诊于北京大学口腔医院修复科,旧义齿戴用7年因基托裂纹要求重新制作全口义齿。口内检查上下颌牙列缺失,剩余牙槽嵴轻至中度吸收,右上前牙前庭沟处缝龈瘤,旧义齿磨光面形态可。软组织调整后,利用模型扫描仪获取旧义齿完整表面形态信息,五轴数控切削复制旧义齿蜡型,重新确定垂直距离、颌位关系及丰满度,硅橡胶翻制初模型,模型上牙合架,更换蜡牙为人工牙,临床试排牙验证颌位关系,边缘整塑制取闭口式印模,灌制终模型,装胶压盒,热处理,制作复制义齿,临床戴牙完成修复治疗,患者填写义齿满意度视觉模拟评分量表(VAS)。结果复制义齿顺利就位,固位力及稳定性好,少量调牙合实现平衡牙合,美观效果好。复查无压痛,义齿咀嚼功能良好。复制义齿VAS评分在总体满意度、易清洁性、发音能力、舒适、美观及嚼碎功能等6个方面均高于97,固位力及稳定性VAS评分达96。结论对于长时间戴用旧义齿无不适、义齿外形满意可复制的患者,利用数字化技术获取旧义齿表面形态,制作复制义齿,实现3次临床就诊完成全口义齿修复,可减少临床就诊次数、简化操作步骤、优化修复效果、提高患者满意度。Objective To report a case of fabrication of duplicate dentures using digital technique for an edentulous patient,and to investigate the workflow and clinical efficacy of this method.Methods A fifty⁃four⁃year old edentulous female with complete dentures which had been worn for seven years and suffered from fissures in the maxilla denture base was recruited.The patient visited the Department of Prosthodontics,Peking University School and Hospital of Stomatology in August 2020.Intraoral examination revealed slightly absorbed residual alveolar ridge and epulis fissuratum at the vestibular sulcus of upper right anterior teeth.After tissue conditioning,a model scanner(3⁃Shape)was used to obtain the complete surface morphological information of the existing dentures.The generated STL file from this technique represented a digital duplicate of the scanned dentures.A set of wax⁃up duplicate dentures were milled by a five⁃axis CNC equipment.The occlusal relationship and fullness were re⁃determined after wax⁃up try⁃in.The initial models reproduced with silicone rubber and jaw relationship were transferred to an articulator.After wax teeth replaced with artificial teeth,the occlusal relationship was verified.After border molding,the wax⁃up was used to take a close⁃mouth impression.The final models were poured using plater.The duplicate dentures were completed after installing the plastic to the press box and heating.The patient′s satisfaction was measured using the visual analogue scale(VAS)after denture delivery.Results The restoration treatment was completed.The duplicate dentures with good retention and stability,and proper extension of the base edge got good aesthetics and high patient′s satisfaction.Occlusal balance was achieved by a bit of adjustment.Follow⁃up visit,the patient had no tenderness,good chewing function and good aesthetic effect.The VAS scores of this patient on the digital duplicate dentures showed high satisfaction.Each score of general satisfaction,cleaning,ability to speak,c

关 键 词：计算机辅助设计 计算机辅助制作 牙列缺失 数字化 义齿 

分 类 号：R783.6[医药卫生—口腔医学]