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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (1): 101-107. doi: 10.19723/j.issn.1671-167X.2023.01.015

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A clinical application study of digital manufacturing simple intraoral Gothic arch-tracing device in determining the centric relation of complete dentures

Tuan-feng ZHOU*(),Xue YANG,Rui-jie WANG,Ming-xuan CHENG,Hua ZHANG,Jin-qi WEI   

  1. First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100034, China
  • Received:2022-10-13 Online:2023-02-18 Published:2023-01-31
  • Contact: Tuan-feng ZHOU E-mail:1442880187@qq.com
  • Supported by:
    the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-21A01)

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Abstract:

Objective: To verify the consistency between the digital manufacturing simple intraoral Gothic arch-tracing device and the traditional intraoral Gothic arch-tracing device in determining the centric relation of complete dentures restoration. Methods: Ten outpatients with edentulous jaws were selec-ted, and the centric relation of the patients was determined by digital manufacturing of simple intraoral Gothic arch-tracing device (T1) and traditional intraoral Gothic arch-tracing device (T2); the difference of clinical operation time between the two methods was recorded; the upper and lower edentulous jaw plaster models were scanned with two kinds of centric relation, the Standard Triangle Language (STL) files imported into Geomagic studio software to apply the best fitting of multiple points of the both upper jaw models, the fitted STL files imported into the 3 shape viewer software, and the maximum position deviations of the vertical, labial (buccal) and lingual directions of the mandibular midline area and molar areas in T1 and T2 groups measured. During the clinical complete dentures try-in, we observed whether there was midline deviation in the mouth of T1 group and T2 group, and whether the occlusion of posterior teeth was stable or not. Results: The mean time spent on determining the centric relation of T1 and T2 groups was (41.90±2.64) min, (57.50±2.37) min respectively. Paired t test was conducted in the two groups, P < 0.01 with significant statistical difference; The mean maximum position deviation between T1 group and T2 group of the midline mandibular region in labial lingual direction was (0.32±0.14) mm, that was (0.40±0.23) mm in vertical direction; the mean maximum position deviation of molar area in buccal lingual direction was (0.35±0.23) mm and that was (0.33±0.20) mm in vertical direction. In the vertical and horizontal directions, the maximum position deviation of mandibles between group T1 and group T2 was controlled within 0.5 mm. In the process of clinical complete dentures try-in, there was no deviation from the center line of dentures. There was not warping, swinging and other poor stability phenomena in T1 and T2 groups. Conclusion: The digital manufacturing of simple intraoral Gothic arch-tracing device can be used to determine the centric relation of complete dentures, which can not only save time of clinical operation, but also ensure the accuracy of the centric relation.

Key words: Digital manufacture, Gothic arch-tracing device, Complete dentures, Centric relation

CLC Number: 

  • R781.0

Figure 1

Design drawing and composition of digital manufacturing simple intraoral Gothic arch-tracing device"

Figure 2

Digital manufacturing simple intraoral Gothic arch-tracing was installed, and the maxillary tracing plate is parallel to the maxillary occlusal plane"

Figure 3

After the maxillary tracing plate and mandibular retainer plate were completely fixed, removed the surrounding 4 support columns"

Figure 4

Checking the vertical distance in the mouth"

Figure 5

Three "↓" trajectories on the maxillary tracing plate after the mandibular protraction and lateral movement were guided by the digital manufacturing simple Gothic arch-tracing"

Figure 6

Defined the top points of three tracing trajectories, aligned them with the center of three circular holes around of the tracing stylus fixing plate, and fixed them"

Figure 7

Fixed the position of 3 tracing stylus with the tracing stylus fixing plate"

Figure 8

Centric relation was determined by digital manufacturing simple intraoral Gothic bow and then fixed with silicone rubber"

Figure 9

Resin tooth arrangement of the complete denture was completed in the articulator"

Figure 10

Try-in the complete denture in the mouth, the upper and lower midlines were aligned, and the posterior teeth occluded stably"

Figure 11

Fitting diagram of upper jaw models in T1 and T2 groups A, 3D diagram of the centric relation between maxilla and mandible in group T1; B, 3D diagram of the centric relation between maxilla and mandible in group T2; C, multi points accurate registration and fitting alignment of 3D images of T1 and T2 maxillary model scans. 1, 2, 3, fitting points of maxilla models."

Figure 12

3D cloud map of upper and lower jaws deviation after maxillaries fitting and alignment of T1 and T2 groups"

Figure 13

To measure the maximum position deviation of the lip-lingual side and vertical direction of the mandibular midline in T1 and T2 groups"

Figure 14

Measurement of the maximum position deviation of buccal-lingual and vertical directions in the left mandibular molar region of T1 and T2 groups"

Figure 15

Measurement of the maximum position deviation of buccal-lingual and vertical directions in the right mandibular molar region of T1 and T2 groups"

Table 1

Clinical operation time of two Gothic arches-tracing in T1 and T2 groups"

Groups Case number Mean±SD P
1 2 3 4 5 6 7 8 9 10
T1/min 46 43 40 45 42 44 39 42 40 38 41.90±2.64 < 0.001
T2/min 62 58 55 61 57 58 56 57 56 55 57.50±2.37

Table 2

Position deviation of both mandibles in the midline region in the labial-lingual and vertical direction after the upper jaws fitting in T1 and T2 groups"

Items Case number Mean±SD
1 2 3 4 5 6 7 8 9 10
Labial-lingual/mm 0.02 0.22 0.47 0.40 0.35 0.34 0.53 0.25 0.31 0.26 0.32±0.14
Vertical/mm 0.01 0.39 0.52 0.21 0.73 0.23 0.62 0.60 0.53 0.20 0.40±0.23

Table 3

Position deviation in buccal-lingual and vertical directions of bilateral mandible posterior areas after both maxillaries fitting in T1 and T2 groups"

Items Case number Mean±SD
1L 1R 2L 2R 3L 3R 4L 4R 5L 5R 6L 6R 7L 7R 8L 8R 9L 9R 10L 10R
Buccal-lingual/mm 0.02 0.05 0.34 0.14 0.78 0.34 0.39 0.12 0.68 0.26 0.36 0.09 0.7 0.4 0.14 0.57 0.62 0.22 0.41 0.27 0.35±0.23
Vertical/mm 0.01 0.03 0.25 0.14 0.54 0.46 0.30 0.21 0.72 0.35 0.40 0.26 0.81 0.23 0.20 0.51 0.45 0.35 0.37 0.30 0.33±0.20
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