数字化正颌外科中锥形束CT重建牙列与激光扫描牙模配准精度影响因素研究  

Registration accuracy of cone beam CT dentition and laser scanning dental mold in digital orthognathic surgery

作　　者：刘露露 林阳阳 侯敏 范娟 罗小云 王媛媛 杨赟琪 Liu Lulu;Lin Yangyang;Hou Min;Fan Juan;Luo Xiaoyun;Wang Yuanyuan;Yang Yunqi(Department of Orthognathic Surgery,Tianjin Stomatological Hospital,School of Medicine,Nankai University,Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction,Tianjin 300041,China;Department of Stomatology,Ninth People’s Hospital of Suzhou,Suzhou 215200,China;Department of Dental Pulp,Dongfeng Dental Hospital,Shiyan 442000,China;Department of Orthodontic,Beijing Gurui Guotai Dental Clinic Co.,Ltd.,Beijing 100020,China)

机构地区：[1]天津市口腔医院正颌外科南开大学医学院天津市口腔功能重建重点实验室,天津300041 [2]苏州市第九人民医院口腔科,苏州215200 [3]国药东风口腔医院牙体牙髓科,十堰442000 [4]北京固瑞国泰口腔门诊部有限公司正畸科,北京100020

出　　处：《中华整形外科杂志》2022年第1期32-39,共8页Chinese Journal of Plastic Surgery

基　　金：天津市临床医学重点学科(口腔医学-口腔颌面外科学)专项基金(HWZX007);天津市口腔医院博硕士青年项目(2019BSQN04)。

摘　　要：目的评价锥形束CT(CBCT)重建牙列与激光扫描牙模配准时,托槽、牙列状态及配准方法3个因素对配准精度的影响。方法回顾性分析天津市口腔医院正颌外科2017年12月至2019年12月接受数字化设计的双颌手术治疗的患者资料。将患者的CBCT及激光扫描牙模(简称光扫牙模)数据导入Mimics 20.0软件,分别采用全局配准、局部配准对非咬合状态及咬合状态CBCT牙列和光扫牙模进行配准操作,分为4组:组1,非咬合状态牙列局部配准;组2,非咬合状态牙列全局配准;组3,咬合状态牙列局部配准;组4,咬合状态牙列全局配准。每组包括3个亚组:A亚组使用3.0 mm距离参数配准1次,B亚组使用3.0、1.5 mm距离参数配准2次,C亚组使用3.0、1.5、0.3 mm距离参数配准3次。借助Geomagic Studio软件的距离分析功能,获得两图像间距离的均方根(RMS)等配准精度数据。亚组间正态分布计量资料比较采用方差分析,各亚组间多重比较采用LSD-t检验;采用多因素方差分析,建立一般线性模型,检验有无托槽、牙列状态及配准方法三者之间是否存在交互作用,再使用单变量检验分析单独效应。结果共纳入24例患者,男7例,女17例,年龄19~30岁,其中12例有正畸金属托槽,12例无托槽。(1)无论有无托槽、咬合/非咬合状态牙列,采用局部配准时均为A亚组的配准方案最优,而采用全局配准时均为C亚组的配准方案最佳。(2)有无托槽、牙列状态、配准方法3个主变量对配准结果的影响均有统计学意义(P<0.05);三者间的交互作用无统计学意义(P>0.05);但有无托槽与牙列状态、有无托槽与配准方法、牙列状态与配准方法两两间交互作用有统计学意义(P<0.05)。结论在CBCT牙列和光扫牙模进行配准时,若使用局部配准法,只需用3.0 mm的距离参数配准1次;若使用全局配准法,需依次按照3.0、1.5、0.3 mm的距离参数设置配准3次。有无托槽、牙列状态、配准方�Objective To analyze the accuracy of digital orthognathic surgery by evaluating the effects of brackets,dentition status and registration method on the accuracy of registration of cone beam computed tomography(CBCT)dentition and laser scanning dental casts.Methods A retrospective analysis of the data of patients who underwent digitally designed maxillary and mandibular surgeries from December 2017 to December 2019 in the Department of Orthognathic Surgery,Tianjin Stomatological Hospital.The CBCT and laser scanning dental mold data of the patients were imported into Mimics 20.0 software to build three-dimensional reconstructed dentition.Global registration and local registration of STL registration were used to register non-occlusal,occlusal CBCT dentition and laser scanning dental molds,which could be divided into four groups.Group 1:non-occlusal dentition using local registration,group 2:non-occlusal dentition using global registration,group 3:occlusal dentition using local registration,group 4:occlusal dentition using global registration.Each group included three subgroups,subgroup A used 3.0 mm distance parameters for registration once,subgroup B used 3.0 and 1.5 mm distance parameters for registration twice,and subgroup C used 3.0,1.5 and 0.3 mm distance parameters for registration three times.With the assistance of the distance analysis function of Geomagic Studio software,the root mean square of the distance between the two images was obtained.The comparison of normal power data between subgroups was performed by analysis of variance,and the multiple comparisons among subgroups were performed by LSD-t test.After testing the normality and homogeneity of variance of the data,a general linear model was established to test the influence of bracket,dentition state and registration method on the accuracy of registration by multi-factor analysis of variance.Results A total of 24 patients were enrolled,7 males and 17 females,aged 19-30 years,12 of which had orthodontic metal brackets and 12 had no brackets.(1)The l

关 键 词：正颌外科学 锥形束CT牙列 激光扫描牙模 配准 托槽 牙列状态 精确度 

分 类 号：R816.98[医药卫生—放射医学]