全数字化上颌赝复体制作与适合性初探

Fabrication of digital maxillary prosthesis and the preliminary evaluation of adaption

目的利用多源数据建模、计算机辅助设计制作全数字化的一体式上颌赝复体,并对其适合性行初步评价。方法利用口内光学扫描数据与计算机断层扫描(Computed Tomography,CT)数据进行融合获得数字化印模,并在获得的模型数据上利用数字化牙科设计软件设计金属支架、阻塞器并排列人工牙,通过三维打印(3D printing,3DP)的方式获得数字化上颌赝复体。对3名患者同期进行传统及数字化赝复治疗,以传统赝复体作为自身对照组,使用硅橡胶加衬法对两者适合性(指义齿组织面与口内软组织间存在的间隙)进行评估比较。结果成功实现上颌赝复体的全数字化制作通路;传统赝复体支架适合性(294.0±64.4)μm、阻塞器适合性(357.8±82.4)μm;数字化赝复体支架适合性(364.6±62.6)μm、阻塞器适合性(345.1±95.5)μm均在临床可接受范围,两组之间无统计学差异。结论数字化赝复治疗是一种简便有效的上颌骨缺损修复方式,其适合性符合临床要求。

Objective The aim of this study is to fabricate a digital maxillofacial prosthesis using multi-source data modeling and computer-aided design/computer-aided manufacturing(CAD/CAM)and to evaluate its clinical application preliminarily.Methods Digital impressions were obtained by integrating the intraoral optical scanning data with the computed tomography(CT)data.Metal framework,obturator,and artificial teeth were designed based on the model data by utilizing dental design software.The definitive prosthesis was manufactured by three-dimensional printing(3DP).Three patients were treated with both the traditional and digital prostheses simultaneously,with the traditional prosthesis serving as its control group.Silicone rubber lining was used to assess the adaption of the two types of prosthesis(the gap between the prosthesis's tissue surface and the intraoral soft tissues).Results The digital fabrication of maxillofacial prosthesis was realized successfully.The adaption of the traditional prosthesis framework and obturator was(294.0±64.4)μm and(357.8±82.4)μm,respectively;and the adaption of digital prosthesis framework and obturator was(364.6±62.6)μm and(345.1±95.5)μm,respectively,which were within the clinically acceptable range,with no statistical difference between the two groups.Conclusion Digital prosthesis is a simple and effective method for maxillofacial defect reconstruction,and its adaption is suitable for clinical application.