基于案例推演数字化微笑设计在前牙美学修复中的应用  

Application of digital smile design based on case-based reasoning in aesthetic restoration of anterior teeth

作　　者：朱国慧 穆雅 Zhu Guohui;Mu Ya(First Department of Prosthodontics,Tianjin Stomatological Hospital,Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction,Tianjin 300041,China)

机构地区：[1]天津市口腔医院口腔修复一科,天津市口腔功能重建重点实验室,天津市300041

出　　处：《中国组织工程研究》2022年第32期5191-5195,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金青年科学基金(62006234),项目参与者:朱国慧;天津市高等学校科技发展基金计划项目(2019KJ173),项目参与者:朱国慧。

摘　　要：背景:为了得到统一的美学修复效果,数字化微笑设计技术被推出并逐渐应用于临床,但是由于软件自带牙体图片的局限性和失真性,其推广遇到了困难。研究发现使用数字化微笑设计软件导入以往相似案例的方法可能优化这一问题,使修复体的设计具有真实性和个性化。目的:通过对比基于案例推演的数字化微笑设计方法和传统的美学修复方法在前牙美学修复时的修复效果,来验证前者的优越性和局限性。方法:选择2018年10月至2020年10月就诊于天津市口腔医院修复科的36例前牙需要美学修复患者,按照就诊顺序随机分2组,试验组采集数码照片并导入软件,结合以往最相似病例的修复体图片进行设计,制作诊断蜡型及诊断饰面,获取数字化微笑设计图和口内三维的预演形态,进行医患沟通,设计调整;对照组使用数码摄影结合比色板比色的传统美学修复方法,每组18例。修复完成后即刻进行患者满意度评价,修复后2周、6个月、12个月,依照改良美国公共卫生署(USPHS)标准对修复体进行临床评估。结果与结论:①患者满意度:试验组患者对修复体形态、颜色方面的满意度高于对照组(P <0.05),两组患者在就诊舒适度、就诊时间方面的满意程度无明显差异(P> 0.05);②临床评估:修复后2周,两组患者在修复体完整性、牙周健康、牙体敏感、边缘适应、颜色匹配及咬合关系方面无明显差异(P> 0.05);修复后6,12个月,试验组患者在修复体颜色匹配方面优于对照组(P <0.05);③结果表明:基于案例推演的数字化微笑设计技术在医患沟通、修复体颜色形态方面优于传统方法,但目前存在以往案例数量有限和数字化微笑设计流程增加了工作量和修复费用的局限性。BACKGROUND:To achieve a unified aesthetic restoration effect,digital smile design technologies have been introduced and gradually applied in clinical practice.However,due to the limitations and authenticity of the software’s own dental pictures,the promotion of the software encountered difficulties.Researchers found that using the digital smile design software to import previous similar cases may optimize this problem,making the design of the prosthesis authentic and personalized.OBJECTIVE:To verify the advantages and limitations of the case-based digital smile design method by comparing the effect of the case-based digital smile design method and the traditional aesthetic resto ration method in the aesthetic resto ration of ante rior teeth.METHODS:From October 2018 to October 2020,36 patients requiring aesthetic restoration of anterior teeth at the Department of Prosthodontics in Tianjin Stomatological Hospital were selected and randomly divided into experimental group and control group according to the sequence of treatment,with 18 patients in each group.In the expe rimental group,digital smile design technology was used to collect and import digital photos,and the diagnostic wax pattern and diagnostic decoration were made based on the pictures of the prostheses from the most similar cases in the past.Patients could obtain the digital smile design drawing and three-dimensional oral preview form for doctor-patient communication and design adjustment.The control group was treated with digital photography combined with colorimetric palettes.Immediately after aesthetic repair,patient satisfaction evaluation was performed.Aesthetic prostheses were clinically evaluated as per the modified United States Public Health Service(USPHS) crite ria at 2 wee ks,6 months,and 12 months after aesthetic repair.RESULTS AND CONCLUSION:In terms of patient satisfaction,patients in the experimental group were more satisfied with the shape and color of the prosthetics than those in the control group(P <0.05),and there was no signific

关 键 词：数字化微笑设计 前牙美学修复 案例推演法 诊断饰面 修复体 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]