不同补偿间隙3D打印正颌手术[牙合]板对咬合精度的影响

Effect of 3D printing orthognathic surgical splints with different dental model offsets on occlusal precision

目的研究不同补偿间隙3D打印正颌手术[牙合]板(OSS)对咬合精度的影响,并探讨制作OSS的最适补偿间隙。方法选取10副符合正常[牙合]咬合标准的树脂模型,使用光学扫描仪获取其数字化模型,利用3D光敏树脂打印机制作树脂研究模型,扫描获取其原始咬合数字化模型。分别对每副模型设计不同补偿间隙(0.00、0.05、0.10、0.15、0.20、0.25 mm)的数字化OSS,并使用3D打印法制作实体OSS。将各副树脂研究模型的上、下牙列重新咬合于不同补偿间隙的OSS上,评估上、下牙列的实际咬合在水平向、矢状向、垂直向、俯仰、滚转、偏航6个维度上较原始咬合的偏差。结果1)使用无补偿间隙(0.00 mm)的OSS,获得的实际咬合在6个维度上均有偏差,垂直向(1.044 mm±0.181 mm)及俯仰(1.738°±0.772°)维度上的偏差最大。2)在矢状向、垂直向、俯仰、滚转维度上,随着补偿间隙的增大,实际咬合的偏差均值逐渐减小。其中在垂直向和俯仰维度上,0.15 mm组所获实际咬合的偏差分别小于0.00、0.05、0.10 mm组(P<0.01),而与0.20、0.25 mm组的差异无统计学意义(P>0.05)。在矢状向和滚转维度,各组间的差异均无统计学意义(P>0.05)。3)在水平向及偏航维度,实际咬合的偏差在0.00~0.20 mm组内随着补偿间隙的增大,偏差均值逐渐减小,而0.25 mm组的实际咬合偏差较0.20 mm组增大,但差异均无统计学意义(P>0.05)。结论设计有补偿间隙的3D打印OSS能够减小实际咬合的偏差,0.15 mm是制作OSS的最适补偿间隙。

Objective This study aimed to assess the precision of 3D-printed orthognathic surgical splints(OSS)with different dental model offsets and explore the optimal offsets of OSS.Methods Ten resin models that met the standard of normal occlusion were selected,and the digital models were obtained by using an optical scanner.The research models were made by using a 3D photosensitive resin printer,and then the original digital models were obtained.Digital OSS with different offsets(0.00,0.05,0.10,0.15,0.20,and 0.25 mm groups)was designed for each model,and physical OSS was fabricated by 3D printing.The upper and lower dentition of each resin model was reoccluded in OSS with different offsets,and the deviation of the actual occlusion from the original occlusion in six dimensions of horizontal,sagittal,vertical,pitch,roll,and yaw was evaluated.Re⁃sults 1)The actual occlusion obtained by OSS without offsets(0.00 mm group)had deviation in six dimen‐sions,and the deviation in vertical(1.044±0.181 mm)and pitch(1.738°±0.772°)dimensions was the largest.2)In sagittal,vertical,pitch,and roll dimensions,the mean value of actual occlusal deviation gradually decreases with the increase of offsets.In the vertical and pitch dimensions,the actual occlusal deviation of the 0.15 mm group was significantly less than that of the 0.00,0.05,and 0.10 mm groups(P<0.01),but no significant difference was found between the 0.20 mm and 0.25 mm groups(P>0.05).In addition,no significant difference in sagittal and roll dimensions was found among the groups(P>0.05).3)In the horizontal and yaw dimensions,within the range of 0.00-0.20 mm,the mean value of actual occlusal deviation gradually decreased with the increase of offsets(P>0.05).However,the actual occlusal deviation of the 0.25 mm group was larger than that of the 0.20 mm group(P>0.05).Conclusion 3D printed OSS with offsets can reduce the deviation of the actual occlusion.Among the parameters,0.15 mm is the suitable option for generating OSS.