患者参与的数字化设计在前牙美学修复中的应用

发布时间：2018-10-13 19:01

【摘要】：目的:探索一种患者能够参与的前牙美学修复的数字化设计、预测和制作方法,为前牙美学修复提供新思路。方法:选取需要进行前牙美学修复的患者32人,随机分为实验组和对照组,每组各16人。实验组通过口内扫描和面部三维扫描获取牙列和面部图像并进行配准,在计算机辅助设计(computer-aided design,CAD)软件中设计修复体,得到三维数字化修复效果图,根据患者意见调整修复体形态后,用牙科计算机辅助制作(computer-aided manufacturing,CAM)设备根据设计好的修复体形态制作前牙修复体。对照组采用常规方法制作修复。记录两组患者初戴修复体时每单位修复体所用时间,请未参与实验的医师对修复体质量进行盲评,并请患者对修复体以及修复后面部整体外观进行满意度评价。结果:成功建立了患者参与的前牙美学修复数字化设计和效果预测流程,并用数字化技术制作出患者满意的前牙修复体。实验组患者对于数字化修复方式的接受率为100%。实验组与对照组的修复体经过未参与实验的医师盲评,在外形准确性、边缘密合性以及表面光滑性上差异均无统计学意义(P0.05)。实验组患者对修复体及修复后面部整体外观的满意度明显高于对照组(P0.05),且实验组修复体初戴时每单位修复体调改时间较对照组明显缩短(P0.01)。结论:患者参与的前牙美学修复的数字化设计、预测和制作方法可行,此方法有助于缩短修复体初戴时间并能够提高患者对修复效果的满意度。
[Abstract]:Objective: to explore a digital design, prediction and fabrication method of anterior tooth aesthetic restoration, which can be participated by patients, and to provide a new idea for aesthetic restoration of anterior teeth. Methods: 32 patients who needed aesthetic restoration of anterior teeth were randomly divided into experimental group (n = 16) and control group (n = 16). In the experimental group, dentition and facial images were acquired and registered by intraoral scanning and 3D facial scanning. The restoration was designed in computer aided Design (computer-aided design,CAD) software, and the three-dimensional digital restoration effect was obtained. After adjusting the shape of the prosthesis according to the patient's opinion, the dental computer-aided fabrication (computer-aided manufacturing,CAM) equipment was used to make the anterior tooth prosthesis according to the designed prosthesis shape. The control group was repaired by routine method. The time of each unit of prosthesis was recorded when the two groups of patients were first worn. Doctors who were not involved in the experiment were asked to evaluate the quality of the prosthesis blindly, and the patients were asked to evaluate the overall appearance of the prosthesis and the whole facial appearance after the restoration. Results: the digital design and effect prediction process of aesthetic restoration of anterior teeth were successfully established, and the satisfactory anterior tooth prosthesis was made with digital technology. The acceptance rate of digital repair was 100 in the experimental group. The prostheses of the experimental group and the control group had no significant difference in shape accuracy edge tightness and surface smoothness after blind evaluation by doctors who did not participate in the experiment (P0.05). The patients in the experimental group had significantly higher satisfaction with the prosthesis and the overall facial appearance after the restoration than the control group (P0.05), and the adjusting time of each unit of the prosthesis in the experimental group was significantly shorter than that in the control group (P0.01). Conclusion: the digital design, prediction and fabrication of aesthetic restoration of anterior teeth involved by patients are feasible. This method can shorten the initial wear time of prosthesis and improve the satisfaction of patients with the effect of restoration.
【作者单位】：北京大学口腔医学院·口腔医院修复科;口腔数字化医疗技术和材料国家工程实验室;北京大学口腔医学院·口腔医院口腔医学计算机应用中心国家卫生和计划生育委员会口腔医学计算机应用工程技术研究中心;
【基金】：国家高技术研究发展计划(863计划,2013AA040801) 新世纪优秀人才支持计划(NCET-11-0026) 北京大学口腔医院新技术新疗法项目资助~~
【分类号】：R783.3

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