乳切牙树脂预成冠的数字化设计方法及初步应用  

Digital Design Method and Application of Preformed Resin Crown for Deciduous Incisors

作　　者：李文博 陈小贤[2] 李静[3] 石冰清 秦庆钊 高梓翔 朱玉佳 温奥楠 单珅瑶 王勇 赵一姣[1,4] LI Wenbo;CHEN Xiaoxian;LI Jing;SHI Bingqing;QIN Qingzhao;GAO Zixiang;ZHU Yujia;WEN Aonan;SHAN Shenyao;WANG Yong;ZHAO Yijiao(Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China;Department of Pediatric Dentistry,First Clinical Division,Peking University School and Hospital of Stomatology,Beijing 100050,China;Department of Pediatric Dentistry,Peking University School and Hospital of Stomatology,Beijing 100081,China;Center of Digital Dentistry/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&NHC Key Laboratory of Digital Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学医学部医学技术研究院,北京100191 [2]北京大学口腔医学院·口腔医院第一门诊部儿童口腔科,北京100050 [3]北京大学口腔医学院·口腔医院儿童口腔科,北京100081 [4]北京大学口腔医学院·口腔医院数字化研究中心/口腔修复教研室、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、国家卫生健康委口腔数字医学重点实验室、口腔数字医学北京市重点实验室,北京100081

出　　处：《口腔医学研究》2024年第5期436-442,共7页Journal of Oral Science Research

基　　金：国家自然科学基金(编号:82271039,82071171);科技部重点研发计划课题(编号:2022YFC2405401);甘肃省重点研发计划项目(编号:21YF5FA165);北大医学顶尖学科及学科群发展专项(编号:BMU2022XKQ003);兰州市创新人才项目(编号:2019-RC-22)。

摘　　要：目的:本研究旨在探索乳切牙树脂预成冠的数字化设计和制作方法,并初步评价其临床适合性。方法:应用牙颌模型扫描仪获取儿童乳牙牙列教学模型4颗上颌乳切牙临床牙冠的三维数据,应用逆向工程软件Geomagic Wrap 2021,参考王慧芸教授对中国儿童乳牙外形的测量和统计数据,对上述上颌乳切牙三维扫描数据进行尺寸比例和三维形态的调整,以切端0.8 mm厚度和唇腭面0.3 mm厚度的牙冠设计参数,构建乳切牙预成冠标准尺寸数字模型。参考儿童口腔科临床常用的上颌乳切牙透明树脂冠各型号间的尺寸比例关系,设计出4个牙位(51、52、61、62)3个型号的乳切牙预成冠数字模型,通过五轴数控切削技术制作出临时冠桥树脂材质的乳切牙预成冠,进行临床病例试戴评价。结果:完成了上颌乳切牙(4个牙位)树脂预成冠的数字化设计和制作方法,并初步进行了临床病例应用,儿科高年资专家对本研究乳切牙树脂预成冠的应用评价显示,其在外观、颜色和强度等方面均可满足口腔儿科临床的应用需求。结论:本研究采用数字化方法设计和制作的乳切牙树脂预成冠,针对儿科临床乳切牙大范围龋损修复的病例,相比传统乳切牙透明树脂冠充填修复技术具有更好的牙冠解剖外形恢复和更佳的美观修复效果,并且该技术可以实现更便捷的临床操作流程,有较好的儿科临床应用前景。Objective:To investigate the digital design and fabrication method for preformed resin crowns in deciduous incisors,and to evaluate their clinical suitability.Methods:The 3D data of the clinical crowns of four maxillary deciduous incisor teeth from a children's deciduous teeth teaching model were obtained using a dentition model scanner.Reverse engineering software Geomagic Wrap 2021 was utilized,with reference to Professor Wang Huiyun's measurement and statistical data on Chinese children's deciduous teeth.Based on the scanned 3D data of maxillary deciduous incisors,adjustments were made to size ratios and 3D shapes.A standard-sized digital model for pre-coronation of deciduous incisors was constructed,incorporating design parameters with incisal end thickness of 0.8mm and lip/palatine surface thicknesses of 0.3mm.Taking into account the size ratio relationship observed in commonly used transparent resin crowns for maxillary incisors in pediatric stomatology departments,digital models for preformed crowns were designed with three types and four positions(51,52,61,and 62).Temporary preformed resin crowns were then fabricated using five-axis CNC cutting technology and subjected to trial evaluations in clinical cases.Results:A digital design and fabrication method for preformed resin crowns in maxillary deciduous incisors across four tooth positions was successfully developed.Initial clinical application demonstrated that these preformed resin crowns met the appearance,coloration,and strength requirements necessary for dental pediatrics practice according to evaluations conducted by senior pediatric experts.Conclusion:The digitally designed and fabricated preformed resin crowns presented in this study exhibit superior anatomical shape restoration compared to traditional transparent resin crown fillings while also achieving better aesthetic outcomes.

关 键 词：乳切牙 预成冠 计算机辅助设计与制作 可切削树脂 

分 类 号：R783[医药卫生—口腔医学]