数字化扫描结合逆向工程技术在全冠牙体预备教学中的应用评价

Application of digital scanning combined with reverse engineering technology in the teaching of full crown preparation

目的探讨数字化扫描结合逆向工程技术在全冠修复体牙体预备教学中的应用。方法采取随机数字表将30名汕头大学医学院口腔医学专业本科五年级学生随机分为两组,两组学生均发放树脂牙两颗,并安装在仿真头模上进行全冠牙体预备。对照组采用经验类比示教法,试验组为采用数字化扫描示教法,即第一次全冠牙体预备完成后进行数字化扫描后进行第二次全冠牙体预备。评分采用《中华口腔医学会团体标准:全瓷冠牙体预备操作规范T/CHSA 008—2023》进行评判,总分为100分。应用SAS 9.4软件对数据进行两独立样本t检验、配对t检验,评分者的一致性采用Kendall W协调系数检验。结果右上颌中切牙(76.27示教前vs.84.70示教后,P<0.001)及右上颌第一磨牙(72.10示教前vs.82.37示教后,P<0.001)示教前后预备体评分的差异有统计学意义。②试验组相对于对照组,右上颌第一磨牙预备体平均提升得分差异有统计学意义(14.00试验组vs.6.53对照组,t=2.64,P=0.014)。③对于试验组,右上颌第一磨牙牙面面(15.40示教前vs.19.33示教后,P<0.001)、颊舌面(18.13示教前vs.20.87示教后,P=0.016)以及邻面(12.40示教前vs.14.07示教后,P=0.004)的分数提升均有统计学意义,颊舌面聚合度(2.80示教前vs.4.07示教后,P=0.004)和邻面(3.47示教前vs.4.47示教后,P=0.008)聚合度在示教后的分数提升均有统计学意义。结论数字化示教应用于难度较高的后牙牙体预备教学可有效提高学生牙体预备质量,规范牙体预备教学流程,提升牙体预备精度,为口腔医学修复人才培养的同质化奠定基础。

Objective To investigate the application of digital scanning combined with reverse engineering technology in the teaching of full crown preparation.Methods A total of 30 undergraduate students in the fifth grade of stomatology were selected from Shantou University Medical College and were divided into experimental group and control group using a random number table.Two resin teeth were distributed to each student and were placed on dental head simulators to perform full crown preparation.The students in the control group received teaching with analogies of experience,and those in the experimental group received teaching with digital scanning,i.e.,full crown preparation for the second time after digital scanning for the first time of full crown preparation.The score was determined based on China Stomatological Association Standards:Guideline for the tooth preparation of dental ceramic crowns(T/CHSA 008—2023),with a total score of 100 points.SAS9.4 software was used for the two-independent-samples t test and the paired t-test,and the Kendall W concordance coefficient was used to investigate the consistency of evaluators.Results There were significant changes after teaching in the preparation scores of the right maxillary central incisor(76.27pre-demonstration vs.84.70post-demonstration,P<0.001)and the right maxillary first molar(72.10pre-demonstration vs.82.37post-demonstration,P<0.001).Compared with the control group,the experimental group had a significant increase in the mean preparation score of the right maxillary first molar(14.00 vs.6.53,t=2.64,P=0.014).In the experimental group,there were significant increases in the preparation scores of the right maxillary first molar for the occlusal surface(15.40pre-demonstration vs.19.33post-demonstration,P<0.001),the buccolingual surface(18.13pre-demonstration vs.20.87post-demonstration,P=0.016),and the proximal surface(12.40pre-demonstration vs.14.07post-demonstration,P=0.004),as well as significant increases in the scores of the convergence angles of the buccolingual surface(2.80pre-demonstration vs.4.07post-demonstration,P=0.004)and the proximal surface(3.47pre-demonstration vs.4.47post-demonstration,P=0.008).Conclusions Application of digital teaching for difficult crown preparation of posterior teeth can effectively improve the quality of crown preparation among students,standardize the teaching process of crown preparation,and increase the precision of crown preparation,thereby laying a foundation for promoting uniformity in talent cultivation for dental prosthodontics.