牙列游离端缺损可摘局部义齿数字化制作流程初探  

Exploration of making distal extension removable partial denture by digital technology

作　　者：冯志宏[1] 钟声 张璇[1] 董会 冯玥 谢瑞[1] 白石柱[1] 方晓梅 朱朋 闫敏 赵铱民[1] Feng Zhihong;Zhong Sheng;Zhang Xuan;Dong Hui;Feng Yue;Xie Rui;Bai Shizhu;Fang Xiaomei;Zhu Peng;Yan Min;Zhao Yimin(Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Xi′an 710032,China)

机构地区：[1]第四军医大学口腔医学院口腔修复科、军事口腔医学国家重点实验室、国家口腔疾病临床医学研究中心、陕西省口腔医学重点实验室,西安710032

出　　处：《中华口腔医学杂志》2023年第4期354-358,共5页Chinese Journal of Stomatology

基　　金：陕西省创新能力支撑计划(2023-CX-PT-27)。

摘　　要：探讨牙列游离端缺失可摘局部义齿的数字化制作流程。选择2021年11月至2022年12月于第四军医大学口腔医学院口腔修复科就诊的牙列游离端缺损患者12例,男性7例,女性5例,年龄(59±3)岁。采用口内扫描技术获取牙列、牙槽嵴及颌位关系的三维模型,常规设计制作并试戴可摘局部义齿金属支架。金属支架就位于口内,再次口内扫描获取牙列、牙槽嵴及金属支架的复合模型,采用虚拟模型置换游离端牙槽嵴数字化印模的方法获取游离端修正模型。在游离端修正模型上设计栓体栓道式树脂基托及人工牙列三维模型,并采用数字化切削技术制作基托及人工牙列树脂模型,利用栓体栓道精准就位基托及人工牙列,并用注塑树脂粘合金属支架、树脂基托及人工牙列,打磨抛光后完成可摘局部义齿的制作。临床试戴后与设计数据对比,结果显示在人工牙列、树脂基托与就位栓体连接杆的连接处以及人工牙列与树脂基托连接处存在0.4~1.0 mm的误差,面误差为0.03~0.10 mm。12例患者戴用义齿后,仅2例患者因压痛而复诊调磨,其余病例未见任何不适。本项研究使用的可摘局部义齿数字化制作流程可基本解决游离端修正模型的数字化制取以及树脂基托、人工牙列与金属支架的装配问题。To explore the digital manufacturing process of distal extension removable partial denture.From November 2021 to December 2022,12 patients(7 males and 5 females)with free-ending situation were selected from the Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University.Three-dimensional model of the relationship between alveolar ridge and jaw position was obtained by intraoral scanning technique.After routine design,manufacturing and try-in of metal framework for removable partial denture,the metal framework was located in the mouth and scanned again to obtain the composite model of dentition,alveolar ridge and metal framework.The free-end modified model is obtained by merging the digital model of free-end alveolar ridge with the virtual model with the metal framework.The three-dimensional model of artificial dentition,and base plate was designed on the free-end modified model,and the resin model were made by digital milling technology.The removable partial denture was made by accurately positioning the artificial dentition and base plate,bonding metal framework with injection resin,grinding and polishing the artificial dentition and resin base.Compared with the design data after clinical trial,the results showed that there was an error of 0.4-1.0 mm and an error of 0.03-0.10 mm in the connection between the resin base of artificial dentition and the connecting rod of the in-place bolt and the connection between artificial dentition and resin base.After denturen delivery,only 2 patients needed grinding adjustment in follow-up visit due to tenderness,and the rest patients did not find any discomfort.The digital fabrication process of removable partial denture used in this study can basically solve the problems of digital fabrication of free-end modified model and assembly of artificial dentition with resin base and metal framework.

关 键 词：义齿 局部 可摘 计算机辅助设计 义齿基托 牙缺失 数字化技术 计算机辅助制作 

分 类 号：R783.4[医药卫生—口腔医学]