不同配准方式对多牙缺失种植修复虚拟[牙合]记录精度的影响  

Impact of different registration methods on the accuracy of virtual occlusal records in implant restoration for multiple missing teeth:an in vitro study

作　　者：田杰华[1] 梅雨芃 黄驿茗 韩雨琪 邸萍[1] 林野[1] Tian Jiehua;Mei Yupeng;Huang Yiming;Han Yuqi;Di Ping;Lin Ye(Department of Implantology,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&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Grade 2021,Five-year Bachelor Degree Program,Peking University School of Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院种植科,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,口腔数字医学北京市重点实验室,北京100081 [2]北京大学口腔医学院2021级口腔医学五年制,北京100081

出　　处：《中华口腔医学杂志》2025年第3期254-261,共8页Chinese Journal of Stomatology

基　　金：北京市自然科学基金(L232099);北京大学口腔医学院大学生创新实验项目(2022-SSDC-29)。

摘　　要：目的探讨4种配准方式对多牙缺失种植修复口内扫描虚拟[牙合]记录精度的影响。方法制备缺失右侧第一磨牙、左侧第二前磨牙、左侧第一磨牙、左侧第二磨牙的多牙缺失种植修复下颌牙颌模型及牙列完整的上颌牙颌模型,上架。于上下颌模型12个处参考位置(16、46、13、43、23、33、25、35、26、36、27、37牙位处)各粘贴1个不锈钢小球(直径为0.5 mm)作为测量标志点。牙颌模型处于最大牙尖交错位,使用牙颌模型扫描仪扫描牙颌模型1次获得参考数据;使用口内扫描仪扫描牙颌模型10次,复制4次,生成40组未进行咬合配准的上下颌数据,再根据计算机产生的伪随机数字表随机分为左侧配准组、右侧配准组、前牙配准组、双侧配准组(每组10组数据),在最大牙尖交错位进行40次颊侧咬合扫描,每种方式重复10次,生成4组虚拟[牙合]记录数据,即左侧配准组、右侧配准组、前牙配准组和双侧配准组。使用逆向工程软件测量不同位置上下颌6对球心间线距(D16-46、D13-43、D23-33、D25-35、D26-36和D27-37,其中D25-35、D26-36、D27-37处于游离端多牙缺失区,D16-46处于单牙缺失区),并与参考模型线距数据作差,计算线性偏差(ΔD)以评估精度,数据负值代表该位置该配准方式低估垂直距离。虚拟[牙合]记录精度数据呈非正态分布,以中位数(四分位数间距)形式表示;正确度以线距偏差的中位数表示,精密度以四分位数间距表示。配准方式和测量项目位置的交互效应用广义线性模型评估,正确度用Kruskal-Wallis检验进行总体比较,检验水准为双侧α=0.05;用Dunn’s t检验进行事后检验,检验水准用Bonferroni法校正。结果虚拟[牙合]记录正确度受配准方式影响(P<0.05),且测量项目位置与配准方式间存在交互效应(P<0.05)。4组中仅双侧配准组游离端多牙缺失区和单牙缺失区的正确度绝对值均<0.1 mm,ΔD16-46、ΔD25-35、ΔD26-36�ObjectiveTo investigate the impact of four registration methods on the accuracy of virtual occlusal records(VOR)in intraoral scanning for implant restorations with multiple missing teeth.MethodsA mandibular model simulating clinical conditions with multiple missing teeth(right first molar,left second premolar,left first molar,left second molar)and a maxillary compete dentition model were mounted on a semi-adjustable articulator.Subsequently,twelve 0.5 mm stainless steel spheres were adhered to reference positions(16,46,13,43,23,33,25,35,26,36,27,37)as fiducial markers.Following this,a laboratory scanner generated reference datasets by digitizing the models in maximum intercuspation(MIP).Meanwhile,ten maxillary and mandibular scans were acquired using an intraoral scanner,with all nonarticulated scans duplicated four times to ensure data consistency.Forty VOR intraoral scans were performed in MIP using four registration protocols:left-side,right-side,anterior,and bilateral registration(n=10 per group),randomized via a computer-generated pseudo-random sequence.For measurement,linear distances(D16-46,D13-43,D23-33,D25-35,D26-36,D27-37,D16-46 represented the single-tooth defect position,whereas D25-35,D26-36,D27-37 reflected positions in free-end edentulism areas)between opposing markers were measured in a reverse engineering software,with deviations(ΔD)from the reference scan calculated to assess accuracy.Specifically,negativeΔD values indicated vertical dimension underestimation.Given that non-normally distributed data were analyzed using medians[interquartile ranges(IQR)],trueness(medianΔD)and precision(IQR)were evaluated.The interaction effect between the registration method and the position of the measurement items was evaluated by using the generalized linear model.The accuracy was compared overall by the Kruskal-Wallis test with the two-sided significance level ofα=0.05.For pairwise comparisons,post-hoc tests were conducted by Dunn′s t-test with the Bonferroni correction for the significance level.Result

关 键 词：牙种植 牙 口内扫描 精度 数字化口腔医学 

分 类 号：R783.6[医药卫生—口腔医学]