【摘要】：目的:針對伴有牙周軟組織形態(tài)不良的復(fù)雜前牙美學(xué)缺陷病例,探索一種全程數(shù)字化修復(fù)的治療流程,為解決復(fù)雜前牙美學(xué)診療問題提供新思路。方法:選取復(fù)雜前牙美學(xué)缺陷的患者12例,通過口內(nèi)和面部三維掃描獲取牙列和面部三維數(shù)據(jù)并進(jìn)行配準(zhǔn),在計(jì)算機(jī)輔助設(shè)計(jì)(computer-aided design,CAD)軟件中進(jìn)行兩種美學(xué)設(shè)計(jì)(僅考慮"白色美學(xué)"、綜合考慮"粉白美學(xué)"),結(jié)合數(shù)碼攝影得到相應(yīng)的彩色三維數(shù)字化修復(fù)效果模擬圖。以患者評分為標(biāo)準(zhǔn)評價(jià)兩種美學(xué)設(shè)計(jì),并由患者自主選擇,針對選擇后一種設(shè)計(jì)的患者,三維打印其診斷模型并制作導(dǎo)板指導(dǎo)牙周手術(shù),后續(xù)采用數(shù)字化方法完成前牙美學(xué)修復(fù)。結(jié)果:患者針對基于口內(nèi)和面部三維掃描及數(shù)碼攝影的兩種數(shù)字化美學(xué)設(shè)計(jì)進(jìn)行評價(jià),綜合考慮"粉白美學(xué)"設(shè)計(jì)的患者滿意度更高(P0.05),且更多患者(66.7%)選擇牙周手術(shù)改善軟組織形態(tài)后再行修復(fù);將該設(shè)計(jì)通過三維打印制作診斷模型及導(dǎo)板指導(dǎo)牙周手術(shù),實(shí)現(xiàn)了數(shù)字化設(shè)計(jì)向最終手術(shù)效果的轉(zhuǎn)移;后續(xù)數(shù)字化方法制作最終修復(fù)體,實(shí)現(xiàn)全程數(shù)字化。結(jié)論:通過數(shù)字化美學(xué)分析和設(shè)計(jì),修復(fù)效果預(yù)測,三維打印診斷模型制作導(dǎo)板指導(dǎo)牙周手術(shù),并用數(shù)字化方法完成前牙美學(xué)修復(fù)診療流程的方法可行,臨床顯著提高醫(yī)生、患者、技師相互間的溝通效率,體現(xiàn)了多學(xué)科聯(lián)合治療復(fù)雜前牙美學(xué)診療問題的優(yōu)勢。
[Abstract]:Objective: to explore a whole process of digital restoration for complex anterior tooth aesthetic defects with poor periodontal soft tissue morphology, and to provide a new way to solve the problem of aesthetic diagnosis and treatment of complex anterior teeth. Methods: 12 patients with complex aesthetic defects of anterior teeth were selected. Dentition and facial 3D data were obtained and registered by 3D scanning in mouth and face, and computer aided design (computer-aided design,) was carried out. Two kinds of aesthetic design (only "white aesthetics" and "whitening aesthetics") were carried out in CAD software, and the corresponding analogue images of color 3D digital restoration effect were obtained by combining digital photography. Two aesthetic designs were evaluated according to the patients' scores, and selected by the patients. For the patients who chose the latter design, the diagnostic model was printed out and the guide plate was made to guide the periodontal surgery. The aesthetic restoration of anterior teeth was completed by digital method. Results: the patients evaluated the two digital aesthetic designs based on intraoral and facial 3D scanning and digital photography, and the patients were more satisfied with the "whitening aesthetics" design (P0.05). More patients (66.7%) chose periodontal surgery to improve the shape of soft tissue before repair. This design is used to make diagnostic model and guide plate to guide periodontal surgery, to realize the transfer of digitized design to final surgical effect, and to make final restoration by subsequent digitization method, so as to realize the whole process digitalization. Conclusion: the digital aesthetic analysis and design, the prediction of restoration effect, the making of three dimensional printing diagnostic model to guide periodontal surgery and the digitalization method to complete the diagnosis and treatment process of anterior tooth aesthetic restoration are feasible, and the doctors can be significantly improved in clinic. The communication efficiency between patients and technicians reflects the advantages of multidisciplinary combined treatment of complex anterior teeth aesthetic diagnosis and treatment.
【作者單位】： 北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院修復(fù)科;北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院牙周科口腔數(shù)字化醫(yī)療技術(shù)和材料國家工程實(shí)驗(yàn)室口腔數(shù)字醫(yī)學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;
【基金】：北京市科學(xué)技術(shù)委員會(huì)首都臨床特色應(yīng)用研究項(xiàng)目(Z141107002514158) 北京大學(xué)口腔醫(yī)院新技術(shù)新療法項(xiàng)目(PKUSSNCT-15B09)資助~~
【分類號】：R783

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