口腔医学研究

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (6): 525-529.DOI: 10.13701/j.cnki.kqyxyj.2024.06.010

• 口腔正畸学研究 • 上一篇    下一篇

基于椅旁设计和3D打印的数字化栅栏式微种植钉导板的应用研究

宋毅1,2, 朱房勇1, 徐小红2, 周涛2, 朱加林2, 许艳华3, 许海凤1, 曹彦南1*   

  1. 1.江南大学附属医院口腔科 江苏 无锡 214122;
    2.泰州职业技术学院 江苏 泰州 225300;
    3.昆明医科大学附属口腔医院正畸科 云南 昆明 650106
  • 收稿日期:2023-11-29 出版日期:2024-06-28 发布日期:2024-06-19
  • 通讯作者: * 曹彦南,E-mail:cyn525@163.com
  • 作者简介:宋毅(1985~ ),男,江苏启东人,硕士,副主任医师,研究方向:数字化口腔种植。
  • 基金资助:
    国家自然科学基金项目(编号:81960195)；无锡市双百医疗卫生拔尖人才项目(编号:HB2023054)；无锡市卫计委面上项目(编号:M202240)；江南大学附属医院临床研究与转化医学研究项目(编号:LCYJ202223、LCYJ202346)；江苏省高职院校青年教师企业实践培训资助项目(编号:2023QYSJ095)

Application Research of Digital Fence Type Miniscrew Guide Plate Based on Chair Side Design and 3D Printing

SONG Yi1,2, ZHU Fangyong1, XU Xiaohong2, ZHOU Tao2, ZHU Jialin2, XU Yanhua3, XU Haifeng1, CAO Yannan1*   

  1. 1. Department of Stomatology, Affiliated Hospital of Jiangnan University, Wuxi 214122, China;
    2. Taizhou Polytechnic College, Taizhou 225300, China;
    3. Department of Orthodontics, Stomatological Hospital Affiliated of Kunming Medical University, Kunming 650106, China
  • Received:2023-11-29 Online:2024-06-28 Published:2024-06-19

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摘要： 目的:评价通过椅旁设计和3D打印制作的数字化栅栏式微种植钉导板在微种植钉植入术中的应用效果。方法:选取需行微种植钉植入的患者15例,术前拍摄口腔颌面部锥形束CT(cone beam computed tomography,CBCT),使用数字化口内扫描仪获得口扫图像,应用3Shape Dental System软件将两者图像拟合后设计导环。导环文件和口扫图像导入Plasty CAD软件,完成栅栏式导板设计。使用椅旁3D打印设备打印导板,光固化后打磨抛光和试戴。在导板引导下植入微种植钉30颗。拍摄术后CBCT,与术前CBCT图像拟合,测量微种植钉实际植入与设计植入的偏差,包括角度偏差和位置偏差,进行精确度分析。测量实际植入的微种植钉与天然牙根的最小间距,评价植入安全性。观察微种植钉植入术后3个月内的固位情况,评价其稳定性。结果:数字化栅栏式导板引导下微种植钉实际植入与设计植入的角度偏差值为(1.25±3.41)°,微种植钉颈部、根部位置与设计植入的偏差值分别为(0.17±0.46) mm、(0.13±0.41) mm,两者比较差异无统计学意义(P＞0.05)。30颗微种植钉与牙根均无接触,安全性Ⅰ级占86.67%,Ⅱ级占13.33%,无Ⅲ级病例。术后3个月内微种植钉均无松动记录,稳固率为100%。结论:数字化栅栏式微种植钉导板能有效提升植入的精确度、安全性和稳定性,椅旁设计和3D打印的制作方式便捷可靠,缩短了治疗周期,具有重要的应用价值。

关键词: 栅栏式, 微种植钉, 导板, 椅旁设计, 3D打印

Abstract: Objective: To evaluate the application effect of digital fence type miniscrew guide plate manufactured by chair side design and 3D printing in implantation surgery of miniscrew. Methods: Fifteen patients who require miniscrew implantation were selected. Cone beam computed tomography (CBCT) of oral and maxillofacial regions was taken before surgery. Digital intraoral scanners were used to obtain oral scan images, and 3Shape Dental System software was used to fit the two images before designing a guide ring. The guide ring file and oral scan image were imported into Plasty CAD software to complete the design of the fence type guide plate. Chair side 3D printing equipment was used to print the guide plate. The plate was polished and trial worn after light curing. Thirty miniscrews were implanted under the guidance of the guide plate. Postoperative CBCT images were taken after surgery and aligned with preoperative CBCT images. The deviation, including angle deviation and position deviation, between the actual implantation and designed implantation was measured to analyze the accuracy. The minimum distance between the actual implanted miniscrew and the natural tooth root was measured to evaluate the safety of implantation. The fixation of miniscrews within 3 months after implantation was observed and the stability was evaluated. Results: The angle deviation between the actual implantation and the designed implantation of the miniscrews guided by the digital fence guide plate was (1.25±3.41)°, and the deviation values between the actual implantation and designed implantation of miniscrews in the neck and root positions were (0.17±0.46) mm and (0.13±0.41) mm, respectively. There was no statistically significant difference (P＞0.05). Thirty miniscrews did not contact with the root of the tooth, with safety level Ⅰ accounting for 86.67% and level Ⅱ accounting for 13.33%. There were no cases of level Ⅲ. Within 3 months after surgery, there was no loosening of the miniscrews, and the stability rate was 100%. Conclusion: The digital fence type miniscrew guide plate can effectively improve the accuracy, safety, and stability of implantation. The chair side design and 3D printing production method are convenient and reliable, which shortens the treatment cycle and has important application value.

Key words: fence type, miniscrew, guide plate, chair side design, 3D printing