【摘要】：目的:探索一種患者能夠參與的前牙美學(xué)修復(fù)的數(shù)字化設(shè)計(jì)、預(yù)測(cè)和制作方法,為前牙美學(xué)修復(fù)提供新思路。方法:選取需要進(jìn)行前牙美學(xué)修復(fù)的患者32人,隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,每組各16人。實(shí)驗(yàn)組通過(guò)口內(nèi)掃描和面部三維掃描獲取牙列和面部圖像并進(jìn)行配準(zhǔn),在計(jì)算機(jī)輔助設(shè)計(jì)(computer-aided design,CAD)軟件中設(shè)計(jì)修復(fù)體,得到三維數(shù)字化修復(fù)效果圖,根據(jù)患者意見(jiàn)調(diào)整修復(fù)體形態(tài)后,用牙科計(jì)算機(jī)輔助制作(computer-aided manufacturing,CAM)設(shè)備根據(jù)設(shè)計(jì)好的修復(fù)體形態(tài)制作前牙修復(fù)體。對(duì)照組采用常規(guī)方法制作修復(fù)。記錄兩組患者初戴修復(fù)體時(shí)每單位修復(fù)體所用時(shí)間,請(qǐng)未參與實(shí)驗(yàn)的醫(yī)師對(duì)修復(fù)體質(zhì)量進(jìn)行盲評(píng),并請(qǐng)患者對(duì)修復(fù)體以及修復(fù)后面部整體外觀進(jìn)行滿意度評(píng)價(jià)。結(jié)果:成功建立了患者參與的前牙美學(xué)修復(fù)數(shù)字化設(shè)計(jì)和效果預(yù)測(cè)流程,并用數(shù)字化技術(shù)制作出患者滿意的前牙修復(fù)體。實(shí)驗(yàn)組患者對(duì)于數(shù)字化修復(fù)方式的接受率為100%。實(shí)驗(yàn)組與對(duì)照組的修復(fù)體經(jīng)過(guò)未參與實(shí)驗(yàn)的醫(yī)師盲評(píng),在外形準(zhǔn)確性、邊緣密合性以及表面光滑性上差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。實(shí)驗(yàn)組患者對(duì)修復(fù)體及修復(fù)后面部整體外觀的滿意度明顯高于對(duì)照組(P0.05),且實(shí)驗(yàn)組修復(fù)體初戴時(shí)每單位修復(fù)體調(diào)改時(shí)間較對(duì)照組明顯縮短(P0.01)。結(jié)論:患者參與的前牙美學(xué)修復(fù)的數(shù)字化設(shè)計(jì)、預(yù)測(cè)和制作方法可行,此方法有助于縮短修復(fù)體初戴時(shí)間并能夠提高患者對(duì)修復(fù)效果的滿意度。
[Abstract]:Objective: to explore a digital design, prediction and fabrication method of anterior tooth aesthetic restoration, which can be participated by patients, and to provide a new idea for aesthetic restoration of anterior teeth. Methods: 32 patients who needed aesthetic restoration of anterior teeth were randomly divided into experimental group (n = 16) and control group (n = 16). In the experimental group, dentition and facial images were acquired and registered by intraoral scanning and 3D facial scanning. The restoration was designed in computer aided Design (computer-aided design,CAD) software, and the three-dimensional digital restoration effect was obtained. After adjusting the shape of the prosthesis according to the patient's opinion, the dental computer-aided fabrication (computer-aided manufacturing,CAM) equipment was used to make the anterior tooth prosthesis according to the designed prosthesis shape. The control group was repaired by routine method. The time of each unit of prosthesis was recorded when the two groups of patients were first worn. Doctors who were not involved in the experiment were asked to evaluate the quality of the prosthesis blindly, and the patients were asked to evaluate the overall appearance of the prosthesis and the whole facial appearance after the restoration. Results: the digital design and effect prediction process of aesthetic restoration of anterior teeth were successfully established, and the satisfactory anterior tooth prosthesis was made with digital technology. The acceptance rate of digital repair was 100 in the experimental group. The prostheses of the experimental group and the control group had no significant difference in shape accuracy edge tightness and surface smoothness after blind evaluation by doctors who did not participate in the experiment (P0.05). The patients in the experimental group had significantly higher satisfaction with the prosthesis and the overall facial appearance after the restoration than the control group (P0.05), and the adjusting time of each unit of the prosthesis in the experimental group was significantly shorter than that in the control group (P0.01). Conclusion: the digital design, prediction and fabrication of aesthetic restoration of anterior teeth involved by patients are feasible. This method can shorten the initial wear time of prosthesis and improve the satisfaction of patients with the effect of restoration.
【作者單位】： 北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院修復(fù)科;口腔數(shù)字化醫(yī)療技術(shù)和材料國(guó)家工程實(shí)驗(yàn)室;北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院口腔醫(yī)學(xué)計(jì)算機(jī)應(yīng)用中心 國(guó)家衛(wèi)生和計(jì)劃生育委員會(huì)口腔醫(yī)學(xué)計(jì)算機(jī)應(yīng)用工程技術(shù)研究中心;
【基金】：國(guó)家高技術(shù)研究發(fā)展計(jì)劃(863計(jì)劃,2013AA040801) 新世紀(jì)優(yōu)秀人才支持計(jì)劃(NCET-11-0026) 北京大學(xué)口腔醫(yī)院新技術(shù)新療法項(xiàng)目資助~~
【分類號(hào)】：R783.3

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