摘要
目的探讨使用模拟压力数字模型进行游离端可摘局部义齿制作技术的应用。方法对21个研究对象采用2种不同方法制作义齿。试验组使用3shape口腔数字印模仪扫描患者口腔软硬组织形态及咬合关系,生成数字模型,与患者CBCT数据一同导入义齿设计软件。依据余留牙位置将CBCT影像与数字模型进行拟合对齐,获得骨形态与对应黏膜厚度信息。对数字模型进行虚拟磨除或缓冲操作,生成模拟压力数字模型,在此模型上设计义齿支架,3D打印支架,最后排牙充胶完成义齿制作。对照组采用模型置换技术获得压力印模模型完成义齿制作。试戴两组义齿进行临床效果评估,测量试验组与对照组游离端黏膜厚度变化量,进行形变差异性分析。结果21个研究对象,试验组黏膜压痛比例为4.76%低于对照组的23.81%。模拟压力数字模型与压力印模模型对应的63个位点黏膜差异性分析显示,近基牙端牙槽嵴顶软组织变形,试验组与对照组没有显著性差异,P=0.11;远基牙端试验组软组织形变显著大于对照组,P=0.000;下颌隆突区试验组比对照组有更多缓冲空间,形态存在显著性差异,P=0.000。结论将数字化印模与CBCT数据拟合进行个性化数字模型修整,可以选择性调整黏膜压力分布,有效缓解游离端可摘局部义齿游离端不均匀下沉及压痛,临床效果满意。
Objective To investigate the application of digital analog pressure model in fabrication of free end removable partial dentures.Methods Two different methods were used to make dentures for 21 subjects.In the experimental group,the soft and hard oral tissue morphology and occlusal relationship of patients were scanned with 3 shape oral digital impression instrument,and the digital model was generated,which was imported into denture design software together with CBCT data of patients.CBCT images and digital model images were fitted and aligned according to the position of remaining teeth to obtain the information of bone morphology and corresponding mucosal thickness.Virtual grinding or buffering operation was carried out on the digital model to generate analog pressure digital model on which the dental prosthesis framework was designed.The framework was 3 D printed and the prosthesis was completed through tooth arrangement and glue filling.In the control group,pressure impression model was obtained by model replacement technique to complete denture fabrication.The clinical effect of two groups of dentures were valued.The change of mucosal thickness in free end of the experimental group and the control group was measured,and the difference of deformation was analyzed.Results Among 21 subjects,the proportion of mucosal tenderness in the experimental group was 4.76%,significantly lower than that in the control group,23.81%.The mucosal differences of 63 sites between the simulated pressure digital model and the pressure impression model were analyzed.There was no significant difference between the experimental group and the control group in soft tissue deformation of alveolar crest near abutment(P=0.11);the soft tissue deformation of distal abutment teeth in the experimental group was significantly greater than that in the control group(P=0.000);in the mandibular protuberance area,the experimental group had more buffer space than the control group,and there was a significant difference in morphology(P=0.000).Conclusion The digital impression is fitted with CBCT data for personalized digital model modification,which can selectively adjust mucosal pressure distribution and effectively relieve uneven subsidence and tenderness of the free end of the removable partial denture.The clinical effect is satisfactory.
作者
张力
姚丽娜
袁玮
刘平燕
林滔
ZHAGN Li;YAO Lina;YUAN Wei;LIU Pingyan;LIN Tao(Department of Prosthetics,Handan Stomatological Hospital,Handan 056001,China)
出处
《口腔医学》
CAS
2021年第12期1111-1116,共6页
Stomatology
基金
河北省卫生厅科技成果推广课题(20191814)。
