数字化口内扫描技术专家共识  

Expert consensus on digital intraoral scanning technology

作　　者：游杰[1] 闫文娟[1] 林丽婷[2] 古文珍[2] 侯雅蓉 肖炜[4] 姚惠[5] 李燕娥[6] 马丽辉 赵蕊妮 邱钧琦 刘建彰[9] 周毅[10] YOU Jie;YAN Wenjuan;LIN Liting;GU Wenzhen;HOU Yarong;XIAO Wei;YAO Hui;LI Yaner;MA Lihui;ZHAO Ruini;QIU Junqi;LIU Jianzhang;ZHOU Yi(Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Affiliated Stomatological Hospital,Sun Yatsen University,Guangzhou 510030,China;Stomatological Hospital,School of Stomatology,Southern Medical University,Guangzhou 510280,China;Affiliated Stomatological Hospital,Guangzhou Medical University,Guangzhou 510145,China;First Affiliated Hospital of Sun Yatsen University,Guangzhou 510030,China;Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Guangzhou,510080,China;Shenzhen People’s Hospital,Shenzhen 518000,China;Shenzhen Stomatology Hospital(Pingshan)of Southern Medical University,Shenzhen 518118,China;Stomatological Hospital,Beijing University,Beijing 100034,China;Stomatological Hospital,Wuhan University,Wuhan 430000,China)

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]中山大学附属口腔医院,广东广州510030 [3]南方医科大学口腔医院(口腔医学院),广东广州510280 [4]广州医科大学附属口腔医院,广东广州510145 [5]中山大学附属第一医院,广东广州510080 [6]广东省人民医院·广东省医学科学院,广东广州510030 [7]深圳市人民医院,广东深圳518000 [8]南方医科大学深圳口腔医院(坪山),广东深圳518118 [9]北京大学口腔医(学)院,北京100034 [10]武汉大学口腔医(学)院,湖北武汉430000

出　　处：《口腔疾病防治》2024年第8期569-577,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金面上项目(82171573);南方医科大学临床研究启动计划(LC2016PY023,NCT03398395)。

摘　　要：数字化口内扫描是近年口腔数字化技术的研究热点,成为口腔正畸、修复、种植的重要技术。数字化口内扫描的精确度和数据资料采集拼接的准确性是保证数字印模成功和加工制作效果的关键;而扫描仪特性、成像原理以及操作者扫描方式、扫描对象、口腔组织特殊性、修复设计方案等均会影响数据采集的准确性。仍有诸多操作者对于如何鉴别不同修复设计的扫描策略、扫描轨迹、如何减少数字化扫描误差等认识不足,且目前国内外学者关于数字化口内扫描技术尚未形成统一标准与共识。为了更好地帮助操作者应对口内扫描中遇到的难题,提高数字化扫描质量,本文集合了参与专家的共同意见,通过对现有证据的归纳鉴别,阐述数字化口内扫描误差的原因与应对方法,掌握不同口腔印模需求下的扫描策略。本专家共识认为,基于影响数字化口内扫描精度及扫描图像重现效果受诸多因素的影响,采用正确的扫描轨迹可缩短临床操作时间,提高扫描的精确性,扫描轨迹主要包括E字法、分段法和S型法等。①进行固定义齿修复时,建议先扫描基牙及前后两个邻牙,再把基牙区域挖出洞型,最后在基牙预备完成后补扫洞型缺口处,既可满足临床实际需求,同时也能得到最可靠的精度。②全口无牙颌行全口义齿修复时,在牙槽嵴底黏膜组织设定标记点、一次性捕获前庭区域的图像、采用不同类型的扫描路径如“Z”形、“S”形、颊腭、腭颊路径、分段扫描牙弓等策略,可以减少扫描误差和改善图像拼接以及重叠的问题。③对于种植修复,当进行种植体支持的单冠修复与小跨度上部结构修复时,建议先预扫所需牙弓,再把基牙区域挖出洞型,最后安装好种植扫描杆后再补扫洞型缺口处;当进行骨水平种植体冠修复时,可通过改良的间接扫描方法,将扫描过程分为三步:首先在口�Digital intraoral scanning is a hot topic in the field of oral digital technology.In recent years,digital intraoral scanning has gradually become the mainstream technology in orthodontics,prosthodontics,and implant dentistry.The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression.However,the operators are less familiar with the intraoral scanning characteristics,imaging processing,operator scanning method,oral tissue specificity of the scanned object,and restoration design.Thus far,no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad.To deal with the problems encountered in oral scanning and improve the quality of digital scanning,we collected common expert opinions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence.We also describe the scanning strategies under different oral impression requirements.The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images,adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy.The scanning trajectories mainly include the Eshaped,segmented,and Sshaped methods.When performing fixed denture restoration,it is recommended to first scan the abutment and adjacent teeth.When performing fixed denture restoration,it is recommended to scan the abutment and adjacent teeth first.Then the cavity in the abutment area is excavated.Lastly,the cavity gap was scanned after completing the abutment preparation.This method not only meets clinical needs but also achieves the most reliable accuracy.When performing full denture restoration in edentulous jaws,setting markers on the mucosal tissue at the bottom of the alveolar ridge,simultaneously capturing images of the vestibular area,using different types of scanning paths such as Zshaped,Sshaped,buccalpalatal and pal

关 键 词：数字化 扫描 口内扫描 数字化技术 数字化口内扫描 精确度 修复 种植 

分 类 号：R78[医药卫生—口腔医学]