数字化修复结合牙周手术解决复杂前牙美学缺陷

发布时间：2019-01-06 07:24

【摘要】：目的:针对伴有牙周软组织形态不良的复杂前牙美学缺陷病例,探索一种全程数字化修复的治疗流程,为解决复杂前牙美学诊疗问题提供新思路。方法:选取复杂前牙美学缺陷的患者12例,通过口内和面部三维扫描获取牙列和面部三维数据并进行配准,在计算机辅助设计(computer-aided design,CAD)软件中进行两种美学设计(仅考虑"白色美学"、综合考虑"粉白美学"),结合数码摄影得到相应的彩色三维数字化修复效果模拟图。以患者评分为标准评价两种美学设计,并由患者自主选择,针对选择后一种设计的患者,三维打印其诊断模型并制作导板指导牙周手术,后续采用数字化方法完成前牙美学修复。结果:患者针对基于口内和面部三维扫描及数码摄影的两种数字化美学设计进行评价,综合考虑"粉白美学"设计的患者满意度更高(P0.05),且更多患者(66.7%)选择牙周手术改善软组织形态后再行修复;将该设计通过三维打印制作诊断模型及导板指导牙周手术,实现了数字化设计向最终手术效果的转移;后续数字化方法制作最终修复体,实现全程数字化。结论:通过数字化美学分析和设计,修复效果预测,三维打印诊断模型制作导板指导牙周手术,并用数字化方法完成前牙美学修复诊疗流程的方法可行,临床显著提高医生、患者、技师相互间的沟通效率,体现了多学科联合治疗复杂前牙美学诊疗问题的优势。
[Abstract]:Objective: to explore a whole process of digital restoration for complex anterior tooth aesthetic defects with poor periodontal soft tissue morphology, and to provide a new way to solve the problem of aesthetic diagnosis and treatment of complex anterior teeth. Methods: 12 patients with complex aesthetic defects of anterior teeth were selected. Dentition and facial 3D data were obtained and registered by 3D scanning in mouth and face, and computer aided design (computer-aided design,) was carried out. Two kinds of aesthetic design (only "white aesthetics" and "whitening aesthetics") were carried out in CAD software, and the corresponding analogue images of color 3D digital restoration effect were obtained by combining digital photography. Two aesthetic designs were evaluated according to the patients' scores, and selected by the patients. For the patients who chose the latter design, the diagnostic model was printed out and the guide plate was made to guide the periodontal surgery. The aesthetic restoration of anterior teeth was completed by digital method. Results: the patients evaluated the two digital aesthetic designs based on intraoral and facial 3D scanning and digital photography, and the patients were more satisfied with the "whitening aesthetics" design (P0.05). More patients (66.7%) chose periodontal surgery to improve the shape of soft tissue before repair. This design is used to make diagnostic model and guide plate to guide periodontal surgery, to realize the transfer of digitized design to final surgical effect, and to make final restoration by subsequent digitization method, so as to realize the whole process digitalization. Conclusion: the digital aesthetic analysis and design, the prediction of restoration effect, the making of three dimensional printing diagnostic model to guide periodontal surgery and the digitalization method to complete the diagnosis and treatment process of anterior tooth aesthetic restoration are feasible, and the doctors can be significantly improved in clinic. The communication efficiency between patients and technicians reflects the advantages of multidisciplinary combined treatment of complex anterior teeth aesthetic diagnosis and treatment.
【作者单位】：北京大学口腔医学院·口腔医院修复科;北京大学口腔医学院·口腔医院牙周科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室;
【基金】：北京市科学技术委员会首都临床特色应用研究项目(Z141107002514158) 北京大学口腔医院新技术新疗法项目(PKUSSNCT-15B09)资助~~
【分类号】：R783

【相似文献】