数字化技术在酸蚀症伴重度磨耗患者功能美学缺陷修复中的应用1例  

Application of digital technology in the repair of functional and aesthetic defects in patients with acid erosion and severe attrition:a case report

作　　者：侯玮玮 郑绪红 陈晓玲 蔡蔚靓 王朝阳 苏智伟[1] 赵鹃[1] Hou Weiwei;Zheng Xuhong;Chen Xiaoling;Cai Weiliang;Wang Chaoyang;Su Zhiwei;Zhao Juan(Dept.of Prosthodontics,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine,Zhejiang Provincial Clinical Research Center for Oral Diseases,Key Laboratory of Oral Biomedical Research of Zhejiang Province,Cancer Center of Zhejiang University,Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province,Hangzhou 310000,China;Dental Laboratory,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine,Hangzhou 310000,China;Dental Digital Center,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属口腔医院口腔修复科·浙江大学口腔医学院·浙江省口腔疾病临床医学研究中心·浙江省口腔生物医学研究重点实验室·浙江大学癌症研究院·口腔生物材料与器械浙江省工程研究中心,杭州310000 [2]浙江大学医学院附属口腔医院口腔工艺科·浙江大学口腔医学院,杭州310000 [3]浙江大学医学院附属口腔医院数字化中心·浙江大学口腔医学院,杭州310000

出　　处：《华西口腔医学杂志》2024年第1期111-120,共10页West China Journal of Stomatology

基　　金：浙江省医药卫生科技计划青年创新人才项目(2022513451);浙江大学医学院附属口腔医院多学科疑难疾病协作诊疗团队项目(RD2022DXKB02,RD2022DXKB01)。

摘　　要：牙磨耗、磨损、酸蚀症等多因素导致的非龋性牙体缺损在口腔临床中的发病率呈上升趋势,通常伴随着不同程度的口腔美学缺陷及功能障碍。对其进行全牙列固定修复咬合重建时,不仅要恢复牙列的形态和美观,更要实现咬合关系与整体口颌系统的协调。本文报道1例酸蚀症伴重度磨耗的病例,利用多模态数字化数据(口内扫描、面部扫描、电子面弓、下颌运动轨迹描记等)构建4D虚拟患者,制定全面的修复方案,进行不同牙齿的个性化微创修复,采用唇贴面、颊贴面、贴面、高嵌体、嵌体、全冠等多种修复体,完成数字化全牙列咬合重建治疗,为该疾病的诊治提供可视化、可全程质控的全局观诊疗策略。Noncarious lesions,a multifactorial condition encompassing tooth attrition,abrasion,and erosion,have a surge in prevalence and required increased attention in clinical practice.These nonbacterial-associated tooth defects can compromise aesthetics,phonetics,and masticatory functions.When providing full-arch fixed occlusal rehabilitation for such cases,the treatment strategy should extend beyond by restoring dentition morphology and aesthetics.This report details a complex case of erosive dental wear addressed through a fully digital,full-arch fixed occlusal rehabilitation.A 4D virtual patient was created using multiple digital data sources,including intraoral scanning,3D facial scanning,digital facebow registration,and mandibular movement tracing.With a comprehensive understanding of the masticatory system,various types of microinvasive prostheses were customized for each tooth,including labial veneers,buccal-occlusal veneers,occlusal veneers,overlays,inlays,and full crowns,were customized for each tooth.The reported digital workflow offered a predictable diagnostic and treatment strategy,which was facilitated by virtual visualization and comprehensive quality control throughout the process.

关 键 词：数字化技术 酸蚀症 磨牙症 咬合重建 

分 类 号：R783[医药卫生—口腔医学]