数字化导板结合3D打印供牙模型在延期自体牙移植中的临床研究

Clinical study of digital guides combined with 3D printed donor tooth models in extended tooth autotransplantation

目的通过数字化导板结合3D打印供牙模型精确制备人工牙槽窝并观察其临床疗效及成功率。方法选取2022年1月至2023年6月就诊于新疆医科大学第一附属医院口腔外科门诊行自体牙移植治疗的患者,分为试验组(用3D模型+数字化导板)与对照组(3D模型)各24例患者。试验组:将患者CBCT影像以DICOM格式导入Mimics软件根据咬合及空间情况匹配合适供牙,三维重建并模拟供牙最佳植入方向,设计并打印供牙的3D模型及导板。术中记录手术操作时间、牙槽窝制备时间、供牙体外时间、供牙试及3D模型试验次数。术后1周及1、3、6、12个月对移植牙进行临床和影像学检查,评估移植牙松动度及牙周组织愈合。结果试验组较对照组供牙离体时间、牙槽窝制备时间、手术操作时间更短,差异有统计学意义(P<0.05)。试验组的供牙及3D模型试验次数更少并有统计学差异(P<0.05)。两组术后1周、3个月、6个月供牙松动度、术前焦虑、术后疼痛得分(1、3、7d)、术后满意度均无统计学差异(P>0.05)。试验组与对照组所有移植牙均达到成功标准,成功率均为100%,两组成功率差异无统计学意义(P>0.05)。结论3D供牙模型结合数字化导板能精确制备人工牙槽窝,缩短牙槽窝制备时间和供牙体外时间。

ObjectiveTo accurately prepare artificial alveolar sockets by using digital guides combined with 3D-printed donor models,and to observe their clinical efficacy and success rate.Methods From January 2022 to June 2023,patients who attended the outpatient clinic of the Department of Oral Surgery of the First Affiliated Hospital of Xinjiang Medical University for the treatment of autogenous tooth transplantation were divided into the experimental group(3D model+digitized surgical guide)and the control group(3D model),each of which consisted of 24 patients.In the experimental group,CBCTimages of the patients were imported into Mimics software in DICOM format to match the donor teeth according to the occlusal and spatial conditions,3D reconstruction was performed to simulate the optimal implantation direction of the donor teeth,and the 3D model of the donor teeth and guide plate were designed and printed.During the operation,the time of surgical operation,the time of socket preparation,the time of donor in vitro,and the number of trials of donor teeth and 3D models were recorded.Clinical and imaging examinations of the grafted teeth were performed at 1 week and 1,3,6,and 12 months postoperatively to assess graft looseness and periodontal tissue healing.Results The donor tooth release time,alveolar socket preparation time,and surgical operation time were shorter in the experimental group than in the control group and were statistically different(P<0.05).The number of tooth donor and 3D model trials was less and statistically different in the experimental group(P<0.05).There were no statistical differences in donor tooth looseness,preoperative anxiety,postoperative pain scores(1,3,and 7 d),and postoperative satisfaction at 1 week,3 months,and 6 months postoperatively between the two groups(P>0.05).All transplanted teeth in the experimental and control groups met the success criteria,and the success rate was 100%,and there was no statistically significant difference in the success rate between the two groups(P>0.05).Conclusion 3D donor tooth model combined with digital guides can accurately prepare artificial tooth sockets and shorten the time of socket preparation and the time of donor tooth in vitro.