国际口腔医学杂志 ›› 2018, Vol. 45 ›› Issue (6): 695-702.doi: 10.7518/gjkq.2018.06.013

• 论著 • 上一篇    下一篇

三维虚拟牙科患者的建立及其在美学修复中的应用

杜雪,瞿方,刘伟才()   

  1. 同济大学口腔医学院和附属口腔医院数字化口腔诊疗中心,上海牙组织修复与再生工程技术研究中心 上海 200072
  • 收稿日期:2018-02-26 修回日期:2018-07-13 出版日期:2018-11-01 发布日期:2018-11-15
  • 通讯作者: 刘伟才 E-mail:vogi@163.com
  • 作者简介:杜雪,住院医师,硕士,Email: 1041928107@qq.com
  • 基金资助:
    上海市科学技术委员会资助项目(17411972500)

Establishment of a three-dimensional virtual dental patient and its application in esthetic restoration

Xue Du,Fang Qu,Weicai Liu()   

  1. Center of Digital Dentistry, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
  • Received:2018-02-26 Revised:2018-07-13 Online:2018-11-01 Published:2018-11-15
  • Contact: Weicai Liu E-mail:vogi@163.com
  • Supported by:
    This study was supported by Science and Technology Commission of Shanghai Municipality(17411972500)

摘要:

目的 通过创建三维虚拟牙科患者,探索一套可行的数字化诊疗流程,辅助美学修复患者进行多学科的诊断和治疗。方法 对需要进行美学修复的患者,将口外面部扫描、口内牙列扫描以及锥形束计算机断层扫描(CBCT)的数据进行处理和整合,创建三维虚拟牙科患者,并与现有的计算机辅助设计和计算机辅助制造(CAD/CAM)设备对接,实现美学修复中以面部轮廓和CBCT引导的,从数字化设计、预测到修复体加工的一整套数字化诊疗流程。结果 成功建立了多学科合作解决前牙美学修复的数字化诊疗流程,通过创建三维虚拟牙科患者进行美学修复是可行的。结论 创建三维虚拟牙科患者进行修复体设计和制作的全数字化诊疗流程,为解决复杂病例提供了一条新的临床路径,对于美学修复、种植手术、正颌手术和正畸治疗有重要的指导意义,能简化患者的治疗流程和就诊次数,从而提高治疗效果及患者满意度。

关键词: 三维虚拟牙科患者, 美学修复, 多学科的诊断和治疗, 数字化诊疗流程, 计算机辅助设计和制作

Abstract:

Objective To explore a feasible digital workflow to enhance the multi-disciplinary diagnosis and treatment (MDT) by establishing three-dimensional (3D) virtual dental patients in esthetic restoration.Methods Patients in need of esthetic restoration in their anterior teeth were included in the study. Extra-oral facial scan, intra-oral scan, and cone beam computed tomography were integrated to establish 3D virtual dental patients, and were then connected with existing computer aided design and computer aided manufacturing equipment. Esthetic restoration was finished with a complete digital workflow to allow the digital design, outcome prediction, and fabrication of definitive restoration from a facial perspective.Results The complete digital workflow of esthetic restorations in MDT mode was successfully established. Esthetic restoration was made feasible through the establishment of 3D virtual dental patients.Conclusion The complete digital workflow undoubtedly provides a new clinical pathway for complicated cases. It is greatly significant for planning esthetic restoration, implant surgery, orthognathic surgery, and orthodontic treatment. The method is useful in reducing appointments and clinical procedures and in improving the therapeutic effect and patient satisfaction.

Key words: three-dimensional virtual dental patient, esthetic restoration, multi-disciplinary diagnosis and treatment, digital workflow, computer aided design and computer aided manufacturing

中图分类号: 

  • R783.3

图 1

数字化诊疗路径"

图 2

三维虚拟牙科患者A:正面观;B:侧面观。"

图 3

虚拟诊断蜡型A:正面观;B:侧面观。"

图 4

美学修复临床实施阶段A:修复前牙列像;B:牙冠延长术;C:硅橡胶导板;D:借助硅橡胶导板制作口内诊断饰面;E:诊断饰面;F:诊断饰面指导牙体预备;G:牙体预备后牙列像;H:修复体设计图;I:修复后牙列像。"

图 5

三维虚拟牙科患者A:正面观;B:侧面观。"

图 6

CAD/CAM设备完成修复体的设计和制作A:牙列设计图;B:面部-牙列设计图;C:最终修复体。"

图 7

牙列像对比图 A:修复前;B:牙冠延长后;C:诊断饰面;D:修复完成后。"

图 8

微笑照对比图 A:修复前;B:修复后。"

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