数字化技术在无牙颌种植义齿颌位关系转移中的应用  

Application of digital technology in the transfer of occlusal relationship of dental implants for edentulous patients

作　　者：戈善为 周卓靓 李林 杨益[1,2,3] 袁之然[1,2,3] 王瑞霞 GE Shanwei;ZHOU Zhuoliang;LI Lin;YANG Yi;YUAN Zhiran;WANG Ruixia(Department of Dental Implantology,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing 210029,China;State Key Laboratory Cultivation Base of Research,Prevention and Treatment for Oral Diseases,Nanjing 210029,China;Jiangsu Province Engineering Research Center of Stomatological Translational Medicine,Nanjing 210029,China;Department of Dental Implantology,Wuxi Stomatology Hospital,Wuxi 214000,China;Department of Denture Development Center,The Affiliated Stomatological Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院口腔种植科,江苏南京210029 [2]口腔疾病研究与防治国家级重点实验室培育建设点,江苏南京210029 [3]江苏省口腔转化医学工程研究中心,江苏南京210029 [4]无锡口腔医院口腔种植科,江苏无锡214000 [5]南京医科大学附属口腔医院义齿研制中心,江苏南京210029

出　　处：《口腔生物医学》2025年第2期87-93,共7页Oral Biomedicine

基　　金：江苏省科教能力提升工程——江苏省研究型医院(YJXYY-JSDW4);江苏省医学创新中心(CXZX202227)。

摘　　要：目的:探讨实现无牙颌种植固定义齿修复患者的数字化动态颌位关系转移和动态咬合调整方法。方法:无牙颌患者植入4~6个种植体,术后即刻使用传统方法制作临时修复体,种植体植入4~6个月后,对患者拍摄锥形束CT、立体摄影测量、口内扫描和下颌运动轨迹描记。将这些数据在设计软件中进行对齐,以获得临时修复体的水平和垂直颌位关系、种植体三维位置信息、软组织信息和虚拟试戴牙合架的三维数据。结合个性化的下颌运动参数进行虚拟动态咬合调整,以完成最终修复。结果:患者的最终修复体实现了良好的正中和侧方咬合接触。口颌系统的组成部分,如咬合、下颌位置、关节和咀嚼肌,实现了良好的功能协调。结论:应用数字化工作流程可以准确制取无牙颌种植固定修复的印模,复制临时修复体的动态颌位关系,并对最终修复体进行动态咬合调整。修复体的咬合适应性得到了优化,并缩短了临床调整时间。Objective:To explore the digital dynamic jaw position transfer and dynamic bite adjustment methods for patients under-going fixed denture restoration with edentulous jaw implants.Methods:Four to six implants were implanted in edentulous patients,and traditional methods were used to create temporary restorations immediately after surgery.Four to six months after implantation,cone beam CT,stereophotogrammetry,intraoral scanning,and mandibular movement trajectory recording were performed on the patients.These data were aligned in the design software to obtain the horizontal and vertical jaw position relationship of the temporary restoration,three-dimensional implant position information,soft tissue information,and three-dimensional data of the virtual trial occlusal frame.Combining personalized mandibular movement parameters with virtual dynamic bite adjustment to complete the final restoration.Re-sults:The patients final restoration achieved good occlusal contact in both centric and lateral positions.The components of the oral and maxillofacial system,such as occlusion,jaw position,temporomandibular joints,and masticatory muscles,achieved functional coordi-nation.Conclusions:The application of digital workflow enables accurate impression production for fixed dental restorations,replicates the dynamic jaw position relationship of temporary restorations,and dynamically adjusts the bite of formal restorations.This approach optimizes the occlusal adaptability of the restoration and reduces clinical adjustment time.

关 键 词：无牙颌 种植 电子面弓 立体摄影测量 

分 类 号：R783.4[医药卫生—口腔医学]