数字化颌位关系转移方法应用于咬合重建的精度研究  

Study on the accuracy of digital jaw relation transfer method for occlusal rehabilitation

作　　者：王宇轩 杨静文[1] 许桐楷[2] 孙玉春[3] 姜婷[1] WANGYu-xuan;YANG Jing-wen;XU Tong-kai;SUNYu-chun;JIANG Ting(Department of Prosthodontics,Peking University School and Hospital of Stomatology&National Clinical Research Center for Oral Diseases&National En-gineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Department of General Dentistry,Peking University School and Hospital of Stomatology,Beijing 100081,China;Center of Digital Dentistry,Faculty of Prosthodontics,Peking University School and Hospital of Sto-matology,National Clinical Research Center for Oral Diseases,National Engineering Laboratory for Digital and Material Technology of Stomatology,Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health,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,北京100081 [2]北京大学口腔医学院·口腔医院综合治疗二科,北京100081 [3]北京大学口腔医学院·口腔医院,口腔医学数字化研究中心,口腔修复教研室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,卫生部口腔医学计算机应用工程技术研究中心,口腔数字医学北京市重点实验室,北京100081

出　　处：《口腔颌面修复学杂志》2022年第2期115-123,共9页Chinese Journal of Prosthodontics

基　　金：北京市科学技术委员会科技计划(项目编号:Z171100001017096);修复科-国家重大疾病多学科合作诊疗能力建设项目(项目编号:303161901)。

摘　　要：目的:使用口内扫描对升高咬合垂直距离后的颌位关系进行数字化转移,并和间接数字化转移方法进行比较,分析两种方法的精确度,探索适用于咬合重建的数字化颌位关系转移方法。方法:选取10名个性正常成人志愿者,制作上下颌压膜式(牙合)垫,模拟临床升高咬合垂直距离的情况。用三种方法为每个志愿者进行颌位关系转移,分别为(1)标准组:(牙合)垫喷涂显影剂后戴入口内扫描全牙列唇颊面咬合作为参考标准(。2)试验组:口内扫描上下颌牙列,(牙合)垫喷涂显影剂后戴入口内,口内扫描双侧后牙区颊侧咬合,通过口扫仪的系统自动配准数字化上下颌牙列模型的颌位关系。(3)对照组:使用间接数字化转移方法:截断(牙合)垫先分段后整合用硅橡胶记录颌位关系,面弓转移上(牙合)架后进行全(牙合)架的模型扫描,完成颌位关系转移。在逆向工程软件(Geomagic Studio&Control 2014,3DSystems,美国)中将三组的上颌模型配准,建立参考坐标系,选取右下中切牙切缘中点,左、右下颌第一磨牙近中颊尖点作为特征点,确定参考平面,分别计算试验组、对照组与标准组下颌的三维偏差的均方根(Root Mean Square,RMS),参考平面角度偏差和下颌特征点在各个方向上的空间偏差,并用配对t检验对组间差异进行统计学分析。结果:试验组的RMS(0.46±0.19 mm)显著小于对照组(1.09±0.17 mm),下颌参考平面角度偏差(0.51±0.42°)显著小于对照组(1.84±1.21°),前牙区特征点分别在x、y、z轴的偏差Δx(0.24±0.17 mm),Δy(0.14±0.10 mm),Δz_(1)(0.26±0.16 mm)和右侧后牙区特征点在z轴的偏差Δz_(2)(0.36±0.24 mm)均显著小于对照组。结论:对于咬合垂直距离升高后的数字化转移方法,口内扫描直接数字化转移方法的误差显著小于间接法,但口内扫描仍存在一定误差,还需进一步优化方法提高精度。Objective:Using the intraoral scanner to digitally transfer the jaw relation of increased occlusal vertical dimension and to compare it with the indirect digital method,and to evaluate the accuracy of two methods,hoping to find out a more appropriate digital jaw relation transfer method for occlusal rehabilitation.Methods:Ten volunteers with individual normal occlusion were enrolled in this study,the maxillary and mandibular occlusal splint wear fabricated to increase occlusal vertical dimension for 3 mm to simulate occlusal rehabilitation.We used three different methods to digitally transfer the jaw relation for each volunteer.(1)Reference group:intraoral scan the buccal surface of maxillary and mandibular denture when wearing the occlusal splint as the reference standard.(2)Experimental group:intraoral scan buccal surface of posterior teeth when wearing the occlusal splint,the intraoral scanner was automatically aligned with theupper and lower digital model,using electronic jaw movement analyzers to record the spatial location between maxillary arch bilateral temporomandibular joints.(3)Control group:using the indirect digital method:using facebow and cross-mounting the cast on articulator,after the upper and lower casts were scanned separately,the buccal data of casts were scanned with the aid of the dental articulator position,registration was carried out utilizing the registration software.The maxillary digital model of three groups in the reverse engineering software was aligned,then we established reference coordinate system and selected mandibular feature points and reference plane.Root mean square(RMS),the distance deviation of feature points and the angle deviation of reference plane were measured in the three groups.Results:RMS of experimental group(0.46±0.19 mm)was statistically smaller than that in the control group(1.09±0.17 mm),the angle deviation of reference plane(0.51±0.42)was statistically smaller than that in the control group(1.84±1.21),the distance deviation of anterior feature points in

关 键 词：计算机模拟 [牙合]架 颌位关系记录 咬合重建 

分 类 号：R783.9[医药卫生—口腔医学]