基于自行数字化隐形矫治设计对正畸轻度复发病例的临床疗效研究  

Efficacy of the chair-side-made clear aligners by digital setup and 3D printing in mild relapse cases

作　　者：李晶[1] 毛渤淳 王林川 周彦恒[1] Li Jing;Mao Bochun;Wang Linchuan;Zhou Yanheng(Department of Orthodontics,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Department of General Dentistry,University of Rochester Eastman Institute for Oral Health,Rochester 14642,USA)

机构地区：[1]北京大学口腔医学院·口腔医院正畸科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,北京100081 [2]罗彻斯特大学伊斯特曼口腔全科,美国罗彻斯特14642

出　　处：《中华口腔正畸学杂志》2022年第1期8-12,共5页Chinese Journal of Orthodontics

基　　金：国家自然科学基金(62076011);北京大学口腔医院新技术新疗法项目(PKUSSNCT-17B14);北京大学口腔医学院青年科研基金(PKUSS20200114)。

摘　　要：目的应用数字化技术实现医师主导下的无托槽隐形矫治器设计制作用于治疗轻度复发病例,评价其临床应用的有效性和牙齿移动精确性。方法本研究为回顾性对照研究。选取简单牙列不齐的轻度复发病例10例,口内扫描获得牙列信息后应用正畸分析软件进行排牙设计并导出各阶段步骤模型数据用于3D打印和压制无托槽矫治器;通过测量隐形矫治后口扫模型与设计终末模型重叠对比的均方根值评价该数字化流程的有效性;将设计终末模型和治疗后口扫模型分别与初始口扫模型以腭皱襞(上颌)和未做移动设计的后牙区(下颌)为基准重叠,测量48颗设计移动的前牙特征点在矢状向、水平向、垂直向的三维坐标变化量,将预测牙齿移动量与实际牙齿移动量进行配对t检验比较,分析该流程制作的无托槽隐形矫治器对牙齿控制的精确性。结果治疗后口内扫描模型与数字化设计终末模型重叠配准后表面距离的均方根值为(0.158±0.028)mm,小于设计步进移动量0.25 mm。配对t检验结果示设计牙齿移动量与实际牙齿移动量在矢状向、水平向、垂直向和整体的差值分别为[(0.06±0.24)mm,P=0.10],[(0.02±0.18)mm,P=0.36],[(-0.06±0.23)mm,P=0.06]和[(0.03±0.32)mm,P=0.59],差异无统计学意义。结论基于医师自行数字化排牙和3D打印制作的无托槽隐形矫治器对简单牙列不齐病例可以进行有效的矫治。Objective To assess the clinical effectiveness and accuracy of tooth movement with chair-side clear aligners fabricated by digital setup and 3-dimensional(3D)printing under the guidance of orthodontists in mild relapse cases.Methods In this retrospective case-control study,10 relapse patients with simple irregularities were selected and intro-oral scanned for the digital dental models with 3shape Trios.The 3shape Ortho Analyzer software was used to setup the digital models and the tooth movement staging.The stage model data were exported for 3D printing and aligner fabrication.After finishing the treatment,the intra-oral scans were used to create the achieved models.Initial and predicted models were obtained from the 3shape Ortho Analyzer software.The effectiveness of the workflow was evaluated by measuring the root mean square value of the overlapping comparison between the predicted and achieved models.The overlapping basis were palatal rugae in the upper and non-movement posterior teeth in the lower.All the 48 anterior teeth which involved active movements were digitized and measured sagitally(mm),horizontally(mm)and vertically(mm)at featured points level.The predicted and achieved tooth movement was compared with paired t test.Results The RMS(root mean square)value of the overlapping comparison between the predicted and achieved models was(0.158±0.028)mm,which was less than the designed movement per stage(0.25 mm).The paired t test showed no statistically significant differences between the amount of predicted tooth movement and achieved tooth movement.The overall mean difference was[(0.03±0.32)mm,P=0.59].The three-dimensional coordinate deviation of the target tooth feature points were[(0.06±0.24)mm,P=0.10]sagittally,[(0.02±0.18)mm,P=0.36]horizontally,and[(-0.06±0.23)mm,P=0.06]vertically.Conclusions The clear aligners fabricated by digital setup and 3-dimensional(3D)printing under the guidance of orthodontists can be used to treat the patients with simple irregularities effectively.

关 键 词：3D打印 数字化模型 隐形矫治器 复发 

分 类 号：R783.5[医药卫生—口腔医学]