数字化技术构建三维颜面对称参考平面在前牙美学修复中的初步应用  

Preliminary application study of digital technology for constructing three-dimensional facial symmetry reference planes in anterior dental esthetic restoration

作　　者：马丽娟 余向海 尹东[1] 朱玉佳 王勇[2] 赵一姣 Ma Lijuan;Yu Xianghai;Yin Dong;Zhu Yujia;Wang Yong;Zhao Yijiao(Dental Department,People′s Hospital of Ningxia Hui Autonomous Region,Ningxia Medical University,Yinchuan 750002,China;Center of Digital Dentistry,Faculty 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&Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]宁夏回族自治区人民医院(宁夏医科大学附属自治区人民医院)口腔科,银川750002 [2]北京大学口腔医学院·口腔医院口腔医学数字化研究中心、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医学计算机应用工程技术研究中心、口腔数字医学北京市重点实验室,北京100081 [3]北京大学医学部医学技术研究院,北京100191

出　　处：《中华口腔医学杂志》2024年第12期1234-1239,共6页Chinese Journal of Stomatology

基　　金：宁夏自然科学基金(2023AAC03494)。

摘　　要：目的探讨运用数字化技术构建三维颜面对称参考平面(SRP)在前牙美学修复中的应用效果及临床适用性。方法采用横断面研究设计,收集2024年2至5月就诊于宁夏回族自治区人民医院口腔科的20例前牙美学修复患者为临床研究对象。分别采用赋权普氏分析(WPA)算法、本体-镜像关联法的普氏分析(PA)算法和迭代最近点(ICP)算法,构建患者三维颜面部模型SRP(WPA、PA、ICP组)。同时,以1名副主任医师定义的SRP为真值(真值组)。比较WPA、PA、ICP组与真值组SRP的角度误差;选择最优的算法构建SRP,结合三维数字化微笑设计构建虚拟患者,设计前牙修复体(算法组),以常规数字化设计的修复体为常规对照组,采用视觉模拟评分法(VAS),由患者对虚拟患者两组前牙修复体的美学修复效果进行综合评分。结果WPA、PA、ICP组SRP角度误差分别为1.43°±0.66°、1.82°±0.88°和4.74°±2.03°,总体差异有统计学意义(F=41.10,P<0.001)。两两比较显示,WPA组SRP角度误差显著小于ICP组和PA组(P<0.05)。以WPA算法构建SRP,并设计前牙修复体。虚拟患者前牙美学修复效果评分结果显示,常规对照组VAS总分为(6.30±1.38)分,算法组VAS总分为(8.09±0.74)分,二者差异有统计学意义(t=-5.49,P<0.001)。结论使用WPA算法构建的SRP与专家定义的真值平面角度误差最小,是临床实践中最佳选择,且患者满意度较高。Objective To explore the impact of digital technology in constructing a three-dimensional(3D)symmetry reference plane(SRP)for esthetic restoration of anterior teeth and to evaluate its clinical applicability.Methods A cross-sectional study was conducted from February to May 2024,involving 20 patients[11 males and 9 females,aged(36.8±11.4)years]who underwent anterior esthetic restorations at the Department of Stomatology,People′s Hospital of Ningxia Hui Autonomous Region.Symmetrical reference planes of patients′3D facial models were constructed using three different algorithms:weighted Procrustes analysis(WPA),Procrustes analysis(PA)based on the ontology-mirror correlation method,and iterative closest point(ICP).The SRP defined by an associate chief physician served as the control(true-value group).The angular errors between each algorithm group and the true-value group were compared.The optimal algorithm was selected and combined with a three-dimensional digital smile design(DSD)to create virtual patients,followed by designing anterior restorations.The visual analogue scale(VAS)was used by patients to score the aesthetic restoration results of the conventional design(control group)and the algorithm-based design(algorithm group).Results The angular errors of the WPA,PA,and ICP groups were 1.43°±0.66°,1.82°±0.88°,and 4.74°±2.03°respectively,with statistically significant differences among the groups(F=41.10,P<0.001).Pairwise comparisons showed that the WPA group had significantly smaller angular errors compared to the PA and ICP groups(P<0.05).The VAS scores for aesthetic restoration were significantly higher in the algorithm group(8.09±0.74)compared to the control group(6.30±1.38)(t=-5.49,P<0.001).Conclusions The SRP constructed using the WPA algorithm demonstrated minimal angular error when compared to the expert-defined SRP and is considered the optimal choice in clinical practice,yielding high patient satisfaction.

关 键 词：美学 牙科 对称参考平面 普氏分析 迭代最近点 数字化微笑设计 数字化口腔医学 

分 类 号：R783[医药卫生—口腔医学]