功能易适数字化全口义齿的自主创新研发

Independent innovation research of functionally suitable denture digital system

根据《第四次全国口腔健康流行病学调查报告》(2018),我国各类无牙颌患者超过2100万人[1]。牙齿全部缺失后如果未能及时修复,会导致咀嚼功能障碍、营养摄入障碍,易导致颞下颌关节疾病甚至诱发心血管疾病等全身系统性疾病[2]。近年来在世界范围兴起的种植义齿能较好地恢复和重建无牙颌患者的口腔功能,但由于患者全身状况、颌骨条件、心理因素和经济状况等各方面的限制,经典的黏膜支持式全口义齿仍是无牙颌患者口颌功能重建的重要治疗手段,并在无牙颌种植修复的术前诊断设计、术中定位以及骨整合期过渡修复等阶段发挥非常重要的作用[3]。传统全口义齿修复治疗的临床操作复杂、患者就诊次数多、制作周期长、对医生和技师的经验依赖程度较高、义齿戴入后功能不容易适合等因素导致愿意做且能做好全口义齿修复的医师越来越少,这种现状导致了巨大的供需矛盾,亟待通过全口义齿技术的创新研发寻找突破口。

Fabrication of conventional complete dentures involves a complex restoration method,requiring significant time and typically involving primary impressions,definitive impressions,jaw relation records,clinic try-in,and complete denture placement,which has been used for nearly a century without change.A novel digital system named Functionally Suitable Denture(FSD)was researched and deve-loped so as to reduce clinical steps,operation difficulties and errors of complete denture restoration.It pioneered a unique diagnostic complete denture aided by computer aided design(CAD)&3D printing,by which,the functional impression,jaw relation,and try-in(3 steps)were simplified to 1 step,thus the number of visits to the dentist was reduced by 2 times.Moreover,for the first time,it put forward a CAD software of template matching based on the expert design,which was an efficient and intelligent design scheme,and the excellent denture experts’experience and skills could be inherited and iterated.The system included the 3D scanner with appropriate accuracy and high efficiency,the CAD software,the special 3D printer and process software,and the innovative clinical operation process.The Patent Cooperation Treaty(PCT)patent international search report showed that all the 15 claims of the technology were of novelty,creativity and industrial utility.All the digital products were independently developed and made by Peking University School and Hospital of Stomatology,China.The design and manufacture process of denture prosthesis was fast,simple and accurate.At the same time,personalized functional and aesthetic matching of the patients after wearing prosthesis was realized.It effectively solved the global problems of“slow,difficult and inaccurate”of the traditional manual technology of complete denture,and brought good news to edentulous patients.Compared with the traditional complete denture treatment,FSD system has a wide range of applications for different types of edentulous patients,including those with severe resorption of the alveolar ridge or a high occlusal force.Furthermore,the low-cost of 3D printers,compared with expensive milling machines,may make the approach more accessible.This review describes that our research is related to the development of the FSD system,including multi-source data acquisition technology,three generations of complete denture design software,3D printing systems of individual tray and complete denture pattern,the clinical and laboratory operation process of the FSD system.