摘要
目的对牙冠延长术数字化手术导板进行分类设计,并评价导板的应用效果。方法个性化设计被动萌出不足的上颌牙列模型20个,分为4组:自由手组(CG)、Ⅰ型导板组(T1G)、Ⅱ型导板组(T2G)、Ⅲ型导板组(T3G),每组5个模型。计算机辅助设计和制作手术导板,由同一术者分别在自由手及三类数字化导板的辅助下进行牙冠延长术。记录手术时间,由第三方专家对手术效果进行评分。同时,邀请专科医生对三类手术导板的应用价值进行同行评议。结果手术效率方面,CG、T1G、T2G、T3G用时分别为:(17.20±0.85)min、(10.56±1.14)min、(6.79±0.19)min、(5.78±0.36)min,4组间差异均有统计学意义(P<0.05)。手术效果方面,3个导板组的牙龈形态和位置评分均显著高于CG(P<0.05),T3G的龈缘弧度、对称性评分显著高于T1G和T2G(P<0.05);此外,T3G牙槽骨弧度、高度和对称性评分显著高于其它组(P<0.05),而使用探针辅助测量的T1G和CG评分显著低于其它组(P<0.05)。应用价值方面,关于个性化设计、切口设计以及预期效率,三种数字化导板的评分均显著优于CG(P<0.05),T3G评分显著优于T1G和T2G(P<0.05);关于简化手术以及预期效果,得分从高到低依次为:T3G、T2G、T1G、CG(P<0.05)。结论冠延长手术Ⅲ型导板的应用效果最佳,Ⅱ型导板优于Ⅰ型导板,3种数字化导板均明显优于自由手。
Objective To classify and design the digital surgical guides for crown lengthening surgery(CLS),and evaluate the application effect of the digital guides.Methods Individually designed maxillary models with altered passive eruption were prepared with a total of twenty.The models were divided into four groups(n=5):typeⅠ,typeⅡ,typeⅢ,and control.Six anterior tooth CLS guides were computer-aided designed and manufactured for experimental groups.CLS was performed by the same surgeon with the free hand and the assistance of three types of digital guides.The operation time was recorded,and the third-party experts evaluated the operation effect.At the same time,different professional dentists were invited to conduct peer reviews on the application value of the three types of surgical guides.Results In terms of surgical efficiency,the time of CG,T1G,T2G and T3G were(17.20±0.85)min,(10.56±1.14)min,(6.79±0.19)min and(5.78±0.36)min,respectively,and the differences among the four groups were statistically significant(P<0.05).In terms of surgical effect,the morphology and position of gingival margin scores of the three guide plate groups were significantly higher than CG(P<0.05),and the gingival margin curvature and symmetry scores of T3G were significantly higher than T1G and T2G(P<0.05).In addition,the alveolar crest curvature,height and symmetry scores of T3G were significantly higher than those of the other groups(P<0.05),while the scores of T1G and CG measured with the help of probe were significantly lower than those of the other groups(P<0.05).In terms of application value,the scores of individual design,incision design and expected efficiency of the three digital guides were significantly better than CG(P<0.05),and the scores of T3G were significantly better than those of T1G and T2G(P<0.05);In terms of simplified surgery and expected effect,the scores from high to low were T3G,T2G,T1G and CG(P<0.05).Conclusion The application effect of typeⅢCLS guide is the best,type II guide is superior to type I guide,and the three digital guides are significantly better than free hand.
作者
李怡
刘明月
吕季喆
周建锋
谭建国
刘晓强
Li Yi;Liu Mingyue;Lyu Jizhe;Zhou Jianfeng;Tan Jianguo;Liu Xiaoqiang(Department of Prosthodontics,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 100081,China;First Clinical Division,Peking University School and Hospital of Stomatology,Beijing 100081,China)
出处
《中华生物医学工程杂志》
CAS
2023年第2期149-156,共8页
Chinese Journal of Biomedical Engineering
基金
中国高校产学研创新基金(2021JH003)
中华口腔医学会青年临床科研基金(CSA-SIS2022-18)。
