探讨数字化修复工艺技术在全口义齿复制中的应用1例  

Application of digital prosthodontic technology in the fabrication of complete-duplicated denture

作　　者：王兵[1] 衡墨笛 国丹妮 潘韶霞[2] 国丽丽 郭天皓 屈健 冯海兰[2] Bing Wang;Modi Heng;Danni Guo;Shaoxia Pan;Lili Guo;Tianhao Guo;Jian Qu;Hailan Feng(Dental Laboratory,Peking University School and Hospital of Stomatology,Beijing,P.R.China;Department of Prosthodontics,Peking University School and Hospital of Stomatology&National Center for 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&Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health&NMPA Key Laboratory for Dental Materials,Beijing P.R.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 [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,国家卫生健康委口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔材料重点实验室

出　　处：《中国口腔医学继续教育杂志》2023年第2期107-115,144,共10页Chinese Journal of Stomatologial Continuing Education

基　　金：北京大学口腔医学院2019年临床新技术新疗法项目(项目编号:PKUSSNCT-19B03)。

摘　　要：目的:通过全口牙列缺失应用数字化复制义齿完成修复的病例,探讨利用数字化技术改进传统方法,制作全口复制义齿的流程及临床应用。方法:采用数字化技术,利用模型扫描仪对旧义齿进行扫描,获取旧义齿的外形数据,使用五轴数控切削设备制作出蜡质暂时复制义齿;在患者口内重新确定垂直距离、颌位关系以及丰满度等;上架完成全口义齿人工牙一对一替换;医师试排牙验证颌位关系,边缘整塑制取闭口式印模;技师灌制终模型,再次上架调,制作蜡型、装盒装胶、热处理,制作完成最终复制义齿;患者戴牙。修复治疗完成。对患者进行满意度调查。结果:复制义齿顺利就位,美观效果好,固位力及稳定性好,少量调即实现平衡。复查无压痛,义齿咀嚼功能良好。复制义齿满意度视觉模拟评分在总体满意度、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96分。结论:对于长期戴用旧义齿无不适、对义齿咬合及外形满意、适合进行复制的患者,利用数字化修复工艺技术获取旧义齿表面形态,最终制作完成复制义齿。数字化复制义齿技术更利于患者尽快适应新义齿,减少患者临床就诊次数、简化临床和技工室操作步骤、优化修复效果,提高患者满意度。Objective:To explore the workflow and clinical efficacy of fabricating duplicate dentures using digital prosthodontic technology.Methods:Using digital techniques,the model scanner was used to obtain the complete surface morphology information of the existing dentures.The generated STL file from this technique represented a digital duplicate of the scanned dentures.A wax-up duplicate denture was milled by five-axis CNC equipment.The occlusal relationship and fullness were re-determined after wax-up tried in.The initial models reproduced with silicone rubber and jaw relationship were transferred to the articulator.After wax teeth replaced with artificial teeth,the occlusal relationship was verified by dentist.After border molding,the wax-up was used to take close-mouth impression.The final models were poured using plater.The duplicate denture was completed after installing the plastic to the press box and heating.The patient’s satisfaction was measured using the visual analogue scale after denture delivery.Results:All restorations of ten patients were completed.The duplicate dentures with good retention and stability,and proper extension of the base edge got good aesthetics and high patients’satisfaction.Occlusal balance was achieved by a bit of adjustment.Follow-up visit,the patients had no tenderness,and had good chewing function and good aesthetic effect.The visual analogue scale scores of the patients of digital dup licate dentures showed high satisfaction.The scores of the patients’satisfaction of duplicate denture were higher than ninety-six in six aspects,including general satisfaction,easy cleaning,pronunciation ability,comfort,aesthetics and chewing function.Conclusions:The digital technology could be used to fabricate duplicate denture for edentulous patient who wore complete denture for a long time without discomfort to reduce clinical visits,simplify the clinical and technical procedures,and improve clinical outcomes and patient’s satisfaction.

关 键 词：全口义齿 复制义齿 计算机辅助设计与制作技术 数控切削技术 数字化 

分 类 号：R78[医药卫生—口腔医学]