国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (6): 621-630.doi: 10.7518/gjkq.2019099

• 专家笔谈 •    下一篇

美学区数字化种植策略与流程

蔡潇潇()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院种植科 成都 610041
  • 收稿日期:2019-08-01 修回日期:2019-09-10 出版日期:2019-11-01 发布日期:2019-11-14
  • 通讯作者: 蔡潇潇 E-mail:dentistcai@hotmail.com
  • 作者简介:蔡潇潇,教授,博士,Email:<email>dentistcai@hotmail.com</email><br/> ·专家简介·<br/>蔡潇潇,女,教授,博士研究生导师,四川大学华西口腔医院种植科副主任。2000年考入四川大学华西口腔医学院,并完成了本、硕、博10年的专业学习。博士期间赴美国哈佛大学牙学院进行了2年的联合培养。曾获2011、2012年中华口腔医学会优秀青年人才奖。回国至今一直从事口腔种植外科、种植修复和口腔修复的临床工作,擅长于前牙美学种植、即刻种植及牙列缺失的种植美学个性化修复。病例荣获2013、2015、2016、2017、2018年北京口腔种植培训中心(BITC)举办的全国口腔种植病例大赛金奖。主持3项国家自然科学基金项目,作为第一作者及通信作者发表国际高水平论文50余篇。国际牙种植学会(ITI)会员,中华口腔医学会种植专业委员会委员,四川省口腔种植专业委员会常务委员
  • 基金资助:
    国家自然科学基金(81471803);国家自然科学基金(81771125)

Digital planning strategies in aesthetic areas

Cai Xiaoxiao()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-08-01 Revised:2019-09-10 Online:2019-11-01 Published:2019-11-14
  • Contact: Xiaoxiao Cai E-mail:dentistcai@hotmail.com
  • Supported by:
    This study was supported by National Natural Science Foundation of China(81471803);This study was supported by National Natural Science Foundation of China(81771125)

摘要:

美学区种植一直是种植治疗的难点,随着数字化技术的发展,美学区种植治疗流程获得了新的内涵。如何从最终的美学效果出发,通过数字化信息采集与处理、美学分析与设计、数字化种植外科、数字化种植修复等贯穿全程的治疗还原最初设计,实现以终为始的目标,是当今数字化时代下的美学区种植治疗的新趋势。数字化微笑设计(DSD)通过参考患者的面型与牙齿形态获得理想的修复体位置、形态;数字化外科导板和导航系统确保了最优化、最合理化的种植体位置和植入方案;数字化技术辅助下的骨增量技术实现了精准、可控的增量效果;数字化辅助的临时与最终修复不仅为患者提供了舒适、高效的就诊体验,更为医生带来更加高效的数字化工作流程。本文阐述了数字化时代下美学区的种植治疗流程,以期能够为临床医生开展美学区种植治疗提供参考。

关键词: 美学区种植, 数字化治疗流程, 精准种植, 治疗策略

Abstract:

Implant treatment in aesthetic zones has always been difficult in implant therapy. With the development of digital technology, the treatment in aesthetic zones acquires new connotation. This article expounds the implant treatment protocol in aesthetic zones in the digital era from the aspects of pre-implant evaluation and design, digital implant surgery, and digital prosthesis. Digital smile design (DSD) achieves the ideal position and shape of the prosthesis by referring to the patient’s face shape and tooth shape. Surgical guide and navigation system ensure the optimal and most rational implant position. The digital aided bone augmentation makes the augmentation effect precise and controllable. Digital aided prosthesis not only provides comfortable experience for patients, but also brings more efficient digital workflow for doctors. In conclusion, this paper elaborates the implant therapy mode of aesthetic area in the digital era, in order to provide reference for clinicians to carry out implant therapy in aesthetic zones.

Key words: aesthetics zone implant, digital workflow, precision implanting, treatment protocol

中图分类号: 

  • R783.4

图 1

DSD及诊断蜡型 A:多颗前牙连续缺失患者微笑相;B:口内照片与患者微笑相拟合;C:进行个性化牙冠形态及位置设计;D:设计好后,患者理想修复体的外形轮廓;E:DSD后患者微笑相;F:根据DSD设计制作的美观蜡型。"

图 2

钛网用于前牙美学区复杂骨缺损 A:骨弓轮廓不足;B:种植体放置在正确的位置,可见明显颊舌向宽度不足;C:骨缺损区域填入Bio-oss骨粉;D:颊侧放置钛网支撑成骨空间,钛钉固位;E:无张力缝合;F:术后CBCT可见颊侧骨量充足。"

图 3

数字化辅助下的钛网骨增量流程 A:数字化设计软件进行虚拟骨增量;B:根据虚拟骨增量进行颌骨模型3D打印;C:在3D打印模型上根据骨增量轮廓进行钛网预弯;D:预弯钛网包含数字化虚拟骨增量信息;E:预弯钛网用于GBR术中指导骨增量范围;F:术后CBCT显示种植体颊侧骨板厚度约2 mm,牙槽嵴轮廓恢复更为符合预期。"

图 4

数字化印模的应用 A:美学区数字化印模扫描;B:美学区数字化临时修复体印模扫描。"

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