乳切牙树脂预成冠的数字化设计方法及初步应用

doi:10.13701/j.cnki.kqyxyj.2024.05.011

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (5): 436-442.DOI: 10.13701/j.cnki.kqyxyj.2024.05.011

乳切牙树脂预成冠的数字化设计方法及初步应用

李文博¹, 陈小贤², 李静³, 石冰清², 秦庆钊⁴, 高梓翔¹, 朱玉佳⁴, 温奥楠⁴, 单珅瑶¹, 王勇^1,4*, 赵一姣^1,4*

1.北京大学医学部医学技术研究院北京 100191;
2.北京大学口腔医学院·口腔医院第一门诊部儿童口腔科北京 100050;
3.北京大学口腔医学院·口腔医院儿童口腔科北京 100081;
4.北京大学口腔医学院·口腔医院数字化研究中心/口腔修复教研室国家口腔医学中心国家口腔疾病临床医学研究中心口腔生物材料和数字诊疗装备国家工程研究中心国家卫生健康委口腔数字医学重点实验室口腔数字医学北京市重点实验室北京 100081

收稿日期:2024-01-04 出版日期:2024-05-28 发布日期:2024-05-22
通讯作者: * 王勇,E-mail:kqcadc@bjmu.edu.cn；赵一姣,E-mail:kqcadcs@bjmu.edu.cn
作者简介:李文博(1998~ ),女,河南周口人,硕士在读,研究方向:数字化口腔医学。
基金资助:
国家自然科学基金(编号:82271039,82071171);科技部重点研发计划课题(编号:2022YFC2405401);甘肃省重点研发计划项目(编号:21YF5FA165);北大医学顶尖学科及学科群发展专项(编号:BMU2022XKQ003);兰州市创新人才项目(编号:2019-RC-22)

Digital Design Method and Application of Preformed Resin Crown for Deciduous Incisors

LI Wenbo¹, CHEN Xiaoxian², LI Jing³, SHI Bingqing², QIN Qingzhao⁴, GAO Zixiang¹, ZHU Yujia⁴, WEN Aonan⁴, SHAN Shenyao¹, WANG Yong^1,4*, ZHAO Yijiao^1,4*

1. Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China;
2. Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100050, China;
3. Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China;
4. Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & NHC Key Laboratory of Digital Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China

Received:2024-01-04 Online:2024-05-28 Published:2024-05-22

摘要/Abstract

摘要： 目的:本研究旨在探索乳切牙树脂预成冠的数字化设计和制作方法,并初步评价其临床适合性。方法:应用牙颌模型扫描仪获取儿童乳牙牙列教学模型4颗上颌乳切牙临床牙冠的三维数据,应用逆向工程软件Geomagic Wrap 2021,参考王慧芸教授对中国儿童乳牙外形的测量和统计数据,对上述上颌乳切牙三维扫描数据进行尺寸比例和三维形态的调整,以切端0.8 mm厚度和唇腭面0.3 mm厚度的牙冠设计参数,构建乳切牙预成冠标准尺寸数字模型。参考儿童口腔科临床常用的上颌乳切牙透明树脂冠各型号间的尺寸比例关系,设计出4个牙位(51、52、61、62)3个型号的乳切牙预成冠数字模型,通过五轴数控切削技术制作出临时冠桥树脂材质的乳切牙预成冠,进行临床病例试戴评价。结果:完成了上颌乳切牙(4个牙位)树脂预成冠的数字化设计和制作方法,并初步进行了临床病例应用,儿科高年资专家对本研究乳切牙树脂预成冠的应用评价显示,其在外观、颜色和强度等方面均可满足口腔儿科临床的应用需求。结论:本研究采用数字化方法设计和制作的乳切牙树脂预成冠,针对儿科临床乳切牙大范围龋损修复的病例,相比传统乳切牙透明树脂冠充填修复技术具有更好的牙冠解剖外形恢复和更佳的美观修复效果,并且该技术可以实现更便捷的临床操作流程,有较好的儿科临床应用前景。

关键词: 乳切牙, 预成冠, 计算机辅助设计与制作, 可切削树脂

Abstract: Objective: To investigate the digital design and fabrication method for preformed resin crowns in deciduous incisors, and to evaluate their clinical suitability. Methods: The 3D data of the clinical crowns of four maxillary deciduous incisor teeth from a children's deciduous teeth teaching model were obtained using a dentition model scanner. Reverse engineering software Geomagic Wrap 2021 was utilized, with reference to Professor Wang Huiyun's measurement and statistical data on Chinese children's deciduous teeth. Based on the scanned 3D data of maxillary deciduous incisors, adjustments were made to size ratios and 3D shapes. A standard-sized digital model for pre-coronation of deciduous incisors was constructed, incorporating design parameters with incisal end thickness of 0.8mm and lip/palatine surface thicknesses of 0.3mm. Taking into account the size ratio relationship observed in commonly used transparent resin crowns for maxillary incisors in pediatric stomatology departments, digital models for preformed crowns were designed with three types and four positions (51, 52, 61, and 62). Temporary preformed resin crowns were then fabricated using five-axis CNC cutting technology and subjected to trial evaluations in clinical cases. Results: A digital design and fabrication method for preformed resin crowns in maxillary deciduous incisors across four tooth positions was successfully developed. Initial clinical application demonstrated that these preformed resin crowns met the appearance, coloration, and strength requirements necessary for dental pediatrics practice according to evaluations conducted by senior pediatric experts. Conclusion: The digitally designed and fabricated preformed resin crowns presented in this study exhibit superior anatomical shape restoration compared to traditional transparent resin crown fillings while also achieving better aesthetic outcomes.

Key words: deciduous incisors, preformed crowns, computer-aided design and manufacturing, CAD/CAM resin

李文博, 陈小贤, 李静, 石冰清, 秦庆钊, 高梓翔, 朱玉佳, 温奥楠, 单珅瑶, 王勇, 赵一姣. 乳切牙树脂预成冠的数字化设计方法及初步应用[J]. 口腔医学研究, 2024, 40(5): 436-442.

LI Wenbo, CHEN Xiaoxian, LI Jing, SHI Bingqing, QIN Qingzhao, GAO Zixiang, ZHU Yujia, WEN Aonan, SHAN Shenyao, WANG Yong, ZHAO Yijiao. Digital Design Method and Application of Preformed Resin Crown for Deciduous Incisors[J]. Journal of Oral Science Research, 2024, 40(5): 436-442.

参考文献

[1] Benjamin RM. Oral health: the silent epidemic [J]. Public Health Rep, 2010, 125(2):158-159.
[2] 秦满,夏斌.儿童口腔医学[M].第3版.北京:北京大学医学出版社,2020.
[3] Walia T, Salami AA, Bashiri R, et al. A randomised controlled trial of three aesthetic full-coronal restorations in primary maxillary teeth [J]. Eur J Paediatr Dent, 2014, 15(2): 113-118.
[4] Kupietzky A, Waggoner WF. Parental satisfaction with bonded resin composite strip crowns for primary incisors [J]. Pediatr Dent, 2004, 26(4): 337-340.
[5] Mathew M, Roopa K, Soni A, et al. Evaluation of clinical success, parental and child satisfaction of stainless steel crowns and zirconia crowns in primary molars [J]. J Family Med Prim Care, 2020, 9(3): 1418-1423.
[6] Donly KJ, Sasa I, Contreras CI, et al. Prospective randomized clinical trial of primary molar crowns: 24-month results [J]. Pediatr Dent, 2018, 40(4): 253-258.
[7] Salami A, Walia T, Bashiri R. Comparison of parental satisfaction with three tooth-colored full-coronal restorations in primary maxillary incisors [J]. J Clin Pediatr Dent, 2015, 39(5): 423-428.
[8] Tang Z, Zhao X, Wang H. Quantitative analysis on the wear of monolithic zirconia crowns on antagonist teeth [J]. BMC Oral Health, 2021, 21(1): 94.
[9] Aiem E, Smal-Faugeron V, Muller-Bolla M. Aesthetic preformed paediatric crowns: systematic review [J]. Int J Paediatr Dent, 2017, 27(4): 273-282.
[10] 冯莎蔚,国慧,王勇,等.乳牙数字化参考牙冠模型的初步构建[J].北京大学学报(医学版),2022,54(2): 327-334.
[11] 王惠芸.我国人牙的测量和统计[J].中华口腔科杂志,1959,7(3): 149-155.
[12] Zahdan BA, Szabo A, Gonzalez CD, et al. Survival rates of stainless steel crowns and multi-surface composite restorations placed by dental students in a pediatric clinic [J]. J Clin Pediatr Dent, 2018, 42(3): 167-172.
[13] Olegário IC, Bresolin CR, Pássaro AL, et al. Stainless steel crown vs bulk fill composites for the restoration of primary molars post-pulpectomy: 1-year survival and acceptance results of a randomized clinical trial [J]. Int J Paediatr Dent, 2022, 32(1): 11-21.
[14] 王军辉.树脂充填与预成冠修复技术在乳牙大面积龋损应用中的对比研究[D].西安:中国人民解放军空军军医大学,2016.
[15] 陈小贤,钟洁,闫文娟,等.树脂冠修复乳前牙的临床效果评价[J].北京大学学报(医学版),2020,52(5): 907-912.
[16] Kupietzky A, Waggoner WE, Galea J. Long-term photographic and radiographic assessment of bonded resin composite strip crowns for primary incisors: results after 3 years [J]. Pediatr Dent, 2005, 27(3): 221-225.
[17] Grewal N, Jha S, Kaur N. Clinical and radiographic success of resin-bonded strip crowns in primary incisors with varying extents of sound tooth structure available for bonding [J]. Int J Clin Pediatr Dent, 2021, 14(4): 454-461.
[18] Wang J, Zhang B, Chen Y, et al. A comparison of the mechanical proprieties of different types of primary tooth restorations: an in vitro study [J]. Clin Oral Investig, 2022, 26(6): 4419-4426.
[19] Baker LH, Moon P, Mourino AP. Retention of esthetic veneers on primary stainless steel crowns [J]. ASDC J Dent Child, 1996, 63(3): 185-189.
[20] Lee H, Chae YK, Lee HS, et al. Three-dimensional digitalized surface and volumetric analysis of posterior prefabricated zirconia crowns for children [J]. J Clin Pediatr Dent, 2019, 43(4): 231-238.
[21] Chun KJ, Lee JY. Comparative study of mechanical properties of dental restorative materials and dental hard tissues in compressive loads [J]. J Dent Biomech, 2014, 5:1758736014555246.
[22] Al-Haj Ali SN, Farah RI. In vitro comparison of microleakge between preformed metal crowns and aesthetic crowns of primary molars using different adhesive luting cements [J]. Eur Arch Paediatr Dent, 2018, 19(6): 387-392.
[23] 赵昕,战德松.CAD/CAM系统及可切削材料在口腔修复的应用现状[J].中国实用口腔科杂志,2013,6(6): 331-337.
[24] Prabhu D, Anantharaj A, Praveen P, et al. A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars [J]. J Indian Soc Pedod Prev Dent, 2022, 40(1): 34-42.
[25] Dursun E, Monnier-Da CA, Moussally C. Chairside CAD/CAM composite onlays for the restoration of primary molars [J]. J Clin Pediatr Dent, 2018, 42(5): 349-354.
[26] Zafar MS. Prosthodontic applications of polymethyl methacrylate (PMMA): An update [J]. Polymers, 2020, 12(10): 1-35.
[27] Alp G, Murat S, Yilmaz B. Comparison of flexural strength of different CAD/CAM PMMA-based polymers [J]. J Prosthodont, 2019, 28(2): e491-e495.
[28] 王军辉,张百泽,陈宇江,等.2013及2022年乳磨牙金属预成冠临床应用情况调查[J].中华口腔医学杂志,2023,58(11):1110-1115.
[29] Pan C, Lan T, Liu P, et al. Comparison of different cervical finish lines of all-ceramic crowns on primary molars in finite element analysis [J]. Materials, 2020, 13(5): 1094.
[30] 唐忠旺,石伟华,夏斌,等.儿童乳磨牙非金属冠设计及关键参数的三维有限元分析[J].中华口腔医学杂志,2022,57(3): 242-250.

乳切牙树脂预成冠的数字化设计方法及初步应用

Digital Design Method and Application of Preformed Resin Crown for Deciduous Incisors

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