基于软硬组织设计并3D打印下颌颊棚区微小种植体导板  

Design and 3D printing of a micro-implant guide for the mandibular buccal shelf region based on soft and hard tissue anatomy

作　　者：王智伟 袁丽仙 刘珂 樊星[3] 刘鑫 Wang Zhiwei;Yuan Lixian;Liu Ke;Fan Xing;Liu Xin(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Department of Orthodontics,School of Stomatology,The Fourth Military Medical University,Xi'an 710032,China;State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Department of Preventive Dentistry,School of Stomatology,The Fourth Military Medical University,Xi'an 710032,China;Department of Orthodontics,Yanan University Affiliated Hospital,Yanan 716000,China)

机构地区：[1]口颌系统重建与再生全国重点实验室、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、空军军医大学口腔医院正畸科,西安710032 [2]口颌系统重建与再生全国重点实验室、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、空军军医大学口腔医院预防科,西安710032 [3]延安大学附属医院口腔医院正畸科,延安716000

出　　处：《中华口腔正畸学杂志》2025年第1期19-23,共5页Chinese Journal of Orthodontics

基　　金：国家口腔疾病临床医学研究中心重点项目(LCA202203)。

摘　　要：目的基于下颌颊棚区的软硬组织解剖结构的三维数据设计并三维打印微小种植体导板,以便实现下颌颊棚区微小种植体的精准植入。方法收集下颌颊棚区需要植入微小种植体1例患者的锥形束CT数据导入医学影像控制系统软件中重建颌骨牙齿的三维模型,在三维模型上虚拟植入微小种植体,获得微小种植体虚拟体的标准镶嵌语言(standard tessellation language,STL)格式文件。收集患者口内扫描STL格式文件并与虚拟体STL格式文件一并导入逆向工程软件中进行配准,建立包含牙齿、软组织黏膜及微小种植体的完整模型。以此模型在3 Shape Dental Manager软件中设计颊棚区微小种植体导板,并通过数字化齿科三维打印机打印导板。术中利用导板植入微小种植体,术后利用锥形束CT评估微小种植体植入的位置和角度。结果通过术后锥形束CT验证,术中使用此微小种植体导板微小种植体植入位置和角度准确,通过将术后锥形束CT与术前虚拟植入微小种植体的锥形束CT进行三维配比重叠显示,钉头部偏差为1.22 mm;钉尖部偏差为0.95 mm。结论通过应用下颌颊棚区微小种植体导板,可提高临床医师在植入微小种植体时的可预测性及准确性。Objective To design and 3D print a guide for the precise implantation of micro-implants in the mandibular buccal shelf region based on the three-dimensional(3D)anatomical data of the soft and hard tissues in this area.Methods Cone beam CT data from a patient requiring micro-implants in the mandibular buccal shelf region was collected and imported into medical imaging control system software to reconstruct a 3D model of the jaw and teeth.Micro-implants were virtually placed onto this 3D model,and the standard tessellation language(STL)format file of the virtual implant was obtained.The patient's intraoral STL scan file was then collected and registered with the virtual implant STL file using reverse engineering software,creating a complete model that included teeth,soft tissue mucosa,and the micro-implant.The buccal shelf region micro-implant guide was then designed using 3Shape Dental Manager software,and the guide was printed with a digital dental 3D printer.During surgery,the guide was used to implant the micro-implant,and post-surgery,cone beam CT was employed to evaluate the position and angle of the implant.Results Postoperative cone beam CT verification showed that the position and angle of the micro-implant using the guide were accurate.The postoperative cone beam CT and preoperative virtual implantation cone beam CT were compared and aligned three-dimensionally,showing that the deviation at the implant head was 1.22 mm,and at the implant tip,the deviation was 0.95 mm.Conclusions The use of the mandibular buccal shelf region guide improves the predictability and accuracy of micro-implant placement by clinicians.

关 键 词：下颌颊棚区 微种植体 3D打印 导板 

分 类 号：R78[医药卫生—口腔医学]