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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (1): 54-61. doi: 10.19723/j.issn.1671-167X.2021.01.009

• 论著 • 上一篇    下一篇

数字化个齿托盘制取下颌全牙列全冠预备体印模的体外评价

徐啸翔1,曹烨1,Δ(),赵一姣2,贾璐3,谢秋菲1   

  1. 1.北京大学口腔医学院·口腔医院,修复科, 国家口腔疾病临床医学研究中心 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,北京 100081
    2.北京大学口腔医学院·口腔医院,口腔医学数字化研究中心, 国家口腔疾病临床医学研究中心 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,北京 100081
    3.北京大学口腔医学院·口腔医院,义齿加工中心 国家口腔疾病临床医学研究中心 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,北京 100081
  • 收稿日期:2020-09-26 出版日期:2021-02-18 发布日期:2021-02-07
  • 通讯作者: 曹烨 E-mail:ye.cao@bjmu.edu.cn
  • 基金资助:
    北京大学口腔医院临床新技术新疗法项目基金(PKUSSNCT-19B14);国家自然科学基金(81800998)

In vitro evaluation of the application of digital individual tooth tray in the impression making of mandibular full-arch crown abutments

XU Xiao-xiang1,CAO Ye1,Δ(),ZHAO Yi-jiao2,JIA Lu3,XIE Qiu-fei1   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    3. Dental Laboratory Center, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2020-09-26 Online:2021-02-18 Published:2021-02-07
  • Contact: Ye CAO E-mail:ye.cao@bjmu.edu.cn
  • Supported by:
    Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-19B14);National Natural Science Foundation of China(81800998)

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摘要：

目的: 建立利用三维扫描、计算机辅助设计和三维打印制作数字化个齿托盘的方法,通过体外研究评价数字化个齿托盘法和常规法制取全牙列全冠预备体印模的效果。方法: 在标准下颌牙列模型上进行14颗树脂牙全冠预备,通过三维扫描获取预备体表面数据。利用牙科修复设计软件在每个预备体上确定边缘线位置,设计作为个齿托盘主体部分的解剖全冠和连接体形态,以及作为容纳印模材料空间的基底冠形态。在生成的个齿托盘主体数据外表面增加辅助固位装置,内表面生成组织终止点。设计及打印全牙列预备体模型1副,常规全牙列个别托盘A、B以及数字化个齿托盘各4副。使用个别托盘A采用一步法对全牙列预备体模型进行聚醚印模制取,使用个别托盘B和数字化个齿托盘采用分段取模方式完成聚醚印模制取,各重复制取4次。记录每次印模制取的时间及印模中每个预备体肩台及轴面/牙合面缺陷的数目,对每个预备体印模质量进行评价,比较两种方法制取印模的预备体合格率和预备体质量分布。结果: 常规法制取全牙列全冠预备体印模中肩台缺陷数目显著多于数字化个齿托盘法,轴面/牙合面缺陷数目差异无统计学意义。数字化个齿托盘法制取印模的预备体合格率高于常规法,预备体质量分布优于常规法。结论: 通过数字化方法可以实现个齿托盘的设计和制作,与常规法相比,数字化个齿托盘法制取全牙列全冠预备体印模效果更好。

关键词: 计算机辅助设计, 三维打印, 义齿修复术, 牙科印模技术

Abstract:

Objective: To establish a method for the production of digital individual tooth tray based on three-dimensional (3D) scan, computer-aided design (CAD) and 3D printing, and to evaluate the effect of impression taking of full-arch crown abutments by digital individual tooth tray technique and conventional method through in vitro study.Methods: The full crown preparation was performed on all the fourteen resin teeth in a standard model of mandibular dentition. The surface data of prepared abutments was collected by 3D scanning. A new project was created in a dental CAD software including all the fourteen teeth in the mandibular dentition. The design modules of anatomy crown and coping were selected for each tooth. The dentition was divided for three sections: right posterior teeth, anterior teeth, and left posterior teeth areas. The connector design was added between the abutments within the same section. The scanned data of the abutments were imported. The occlusal plane and insertion path were determined. The position of margin line, as well as the shape of anatomy crown and connector as the main body of the individual tooth tray were designed for each abutment. The shape of coping was generated as the space for holding the impression material. The finalized data of the main body was imported into Geomagic software. The retentive attachment was added at the external surface and the tissue stop was formed at the internal surface. The completed individual tooth tray was manufactured by 3D printing with resin material. The data of full-arch crown abutments were modified and printed. The conventional dentition trays A and B, as well as digital individual tooth tray were designed and printed for four copies each. The polyether impressions of the full-arch abutments were made by conventional one-step method using dentition tray A, and by sectional-impression technique using digital individual tooth tray and dentition tray B for four times each. The time spent for each impression taking and the numbers of defects at the shoulder and axial/occlusal surface in each impression were recorded. The impression quality of each abutment was evaluated. The overall quality distribution and the pass rate of abutments between the two methods were analyzed.Results: The impressions made by conventional method had more defects at shoulder than those made by digital individual tooth tray technique. No difference of the number of defects at axial/occlusal surface between the two methods was observed. The digital individual tooth tray technique for the full-arch abutment impression exhibited higher pass rate of abutments and better quality of impression, compared with conventional methods.Conclusion: A new method for the production of digital individual tooth tray based on digital scanning, CAD and 3D printing was established. Compared with conventional method, using digital individual tooth tray technique for impression taking of full-arch abutments can achieve better effect.

Key words: Computer-aided design, Three-dimensional printing, Prosthodontics, Dental impression technique

中图分类号: 

  • R783.6

图1

下颌牙列全冠预备体模型的制备"

图2

数字化个齿托盘的设计流程"

图3

三维打印制作全牙列预备体模型、数字化个齿托盘及常规全牙列个别托盘"

图4

常规法和数字化个齿托盘法制取的全牙列预备体聚醚印模"

表1

常规法与数字化个齿托盘法制取全牙列预备体印模的制取时间、印模缺陷数和预备体合格率"

Group Time/s Number of defects at shoulder Number of defects at axial/occlusal surface Pass rate of abutments
Conventional method
1 360 6 6 78.6%
2 360 7 0 85.7%
3 360 2 9 85.7%
4 360 3 8 85.7%
x-±s 360±0 4.5±2.4 5.8±4.0 83.9%±3.6%
Digital individual tooth tray technique
1 635 0 9 100.0%
2 647 1 2 100.0%
3 641 0 5 100.0%
4 643 1 6 100.0%
x-±s 642±5 0.5±0.6 5.5±2.9 100.0%±0.0%

表2

常规法和数字化个齿托盘法制取全牙列预备体印模中的预备体印模质量分布"

Group Quality of abutments (number of units)
Excellent Good Qualified Unqualified
Conventional method 24 16 7 9
Digital individual tooth tray technique 36 18 2 0
[1] 冯海兰, 徐军. 口腔修复学 [M]. 2版. 北京: 北京大学医学出版社, 2013: 92-95.
[2] Shillingburg HT, Sather DA, Wilson EL, et al. Fundamentals of fixed prosthodontics[M]. 4th ed. London: Quintessence Publi-shing Company, 2012: 291-325.
[3] Jung BY, Lee KW. Alternative impression technique for multiple abutments in difficult case to control[J]. J Adv Prosthodont, 2010,2(1):1-3.
doi: 10.4047/jap.2010.2.1.1 pmid: 21165179
[4] Cannistraci AJ. A new approach to impression taking for crown and bridge[J]. Dent Clin North Am, 1965,29(3):33-42.
[5] Kimmelman BB, Lerman H. Impressions of single preparations using a copper band-shell[J]. J Prosthet Dent, 1971,26(2):154-158.
doi: 10.1016/0022-3913(71)90047-3 pmid: 4933161
[6] Hoffman JM. Nontraumatic final impressions for fixed partial dentures[J]. Prosthodont, 1992,1(1):61-64.
[7] Dimashkieh MR, Morgano SM. A procedure for making fixed prosthodontic impressions with the use of preformed crown shells[J]. J Prosthet Dent, 1995,73(1):95-96.
doi: 10.1016/s0022-3913(05)80277-x pmid: 7699606
[8] Matsumoto W, de Almeida Antunes RP, Fernandes RM, et al. Shell tray impression: a technique modification[J]. J Dent Pub H, 2018,9(1):8-16.
doi: 10.17267/2596-3368dentistry.v9i1
[9] de Sá AT, de Freitas CA, de Sá FC, et al. Effect of cervical relining of acrylic resin copings on the accuracy of stone dies obtained using a polyether impression material[J]. J Appl Oral Sci, 2008,16(1):7-11.
doi: 10.1590/s1678-77572008000100003 pmid: 19089282
[10] 林侠, 赵辉. 固定修复印模方法的比较[J]. 现代口腔医学杂志, 2001,15(4):318.
[11] 唐震宇, 钱成明, 王辉, 等. 个齿托盘对硅橡胶印模颈缘清晰度影响的临床研究[J]. 口腔医学研究, 2015,31(6):613-615.
[12] 林侠, 王梅. 个齿托盘法的应用介绍[J]. 大连医科大学学报, 1997,19(4):303.
[13] Su TS, Sun J. Comparison of repeatability between intraoral digital scanner and extraoral digital scanner: An in-vitro study[J]. J Prosthodont Res, 2015,59(4):236-242.
doi: 10.1016/j.jpor.2015.06.002 pmid: 26211702
[14] Kihara H, Hatakeyama W, Komine F, et al. Accuracy and practicality of intraoral scanner in dentistry: A literature review[J]. J Prosthodont Res, 2020,64(2):109-113.
doi: 10.1016/j.jpor.2019.07.010 pmid: 31474576
[15] 曹悦, 陈俊锴, 赵一姣, 等. 口内三维扫描技术临床应用精度的研究进展[J]. 中华口腔医学杂志, 2020,55(3):201-205.
[16] Beier US, Kranewitter R, Dumfahrt H. Quality of impressions after use of the Magic FoamCord gingival retraction system: a clinical study of 269 abutment teeth[J]. Int J Prosthodont, 2009,22(2):143-147.
pmid: 19418859
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ISSN 1671-167X
CN 11-4691/R
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