国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (3): 317-327.doi: 10.7518/gjkq.2026216

• 数字化专栏 • 上一篇    

基于3种不同数字化方法设计下颌第一磨牙咬合面的精度比较研究

单珅瑶1(),秦庆钊2,李文博1,高梓翔2,温奥楠2,朱玉佳2,王勇2,赵一姣1()   

  1. 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 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 国家卫生健康委员会口腔数字医学重点实验室（中国医学科学院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:2024-11-18 修回日期:2025-10-11 出版日期:2026-05-01 发布日期:2026-04-24
  • 通讯作者: 赵一姣
  • 作者简介:单珅瑶，学士，Email：shenyaoshan@stu.pku.edu.cn
  • 基金资助:
    国家重点研发计划(2022YFC2405401);北京市自然科学基金(L232100);北京市自然科学基金(L242132);国家自然科学基金(82271039);国家自然科学基金(820711-71)

Comparative study on the accuracy of designing the occlusal surface of mandibular first molar based on three different digital methods

Shenyao Shan1(),Qingzhao Qin2,Wenbo Li1,Zixiang Gao2,Aonan Wen2,Yujia Zhu2,Yong Wang2,Yijiao Zhao1()   

  1. 1.Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
    2.Center of Digital Dentistry/Department of Prosthodontics/Central Laboratory, 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 & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology (Key Laboratory of Digital Stomatology, Chinese Academy of Medical Sciences) & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2024-11-18 Revised:2025-10-11 Online:2026-05-01 Published:2026-04-24
  • Contact: Yijiao Zhao
  • Supported by:
    National Key Research and Development Plan of China(2022YFC2405401);Beijing Natural Science Foundation(L232100);National Natural Science Foundation of China(82271039)

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摘要：

目的 通过数字化设计修复体咬合面的模型实验，比较基于轨迹的全可调𬌗架个性化参数、下颌运动轨迹和动态颌位关系指导设计下颌第一磨牙修复体咬合面的准确性。 方法 招募符合纳入标准的12例志愿者（男性4例，女性8例），平均年龄29.5岁。使用3Shape Trios 3口内扫描仪获取受试者上下颌三维牙列模型，并应用动态咬合记录功能采集其前伸、左右侧方运动的动态颌位关系，以及使用Zebris JMA Optic和ModjawTM下颌运动分析系统同样采集受试者前伸、左右侧方运动的下颌运动轨迹，并基于Zebris JMA Optic系统记录的下颌运动轨迹获取全可调𬌗架对应的个性化参数。使用逆向工程软件将原始模型中下颌第一磨牙按照𬌗贴面牙体预备标准进行虚拟预备，获取下颌工作模型。在修复设计软件中分别借助全可调𬌗架参数（Articulator组）、下颌运动轨迹（JMA组、Modjaw组）、动态颌位关系（PSM组）数字化设计下颌第一磨牙𬌗贴面的咬合面。通过逆向工程软件对不同方法设计的修复体咬合面形态与受试者原始天然牙咬合面形态进行偏差分析，采用多个测量学指标比较不同方法设计的修复体咬合面精度。 结果 Articulator组、JMA组、Modjaw组和PSM组的平均正偏差指标，组间差异无统计学意义（P>0.05）；而平均负偏差、平均偏差及均方根指标，组间差异具有统计学意义（P<0.05）。Articulator组的平均负偏差（-96.2±15.8）μm大于JMA组（-160.1±44.4）μm、Modjaw组（-141.6±33.2）μm和PSM组（-233.6±28.5）μm；Articulator组的平均偏差（172.5±113.0）μm大于JMA组（19.2±132.6）μm、Modjaw组（70.3±121.3）μm和PSM组（-66.8±129.1）μm，差异具有统计学意义（P<0.05）。 结论 基于轨迹的全可调𬌗架个性化参数、下颌运动轨迹和动态颌位关系指导设计的下颌第一磨牙修复体咬合面形态与原始天然牙咬合面形态之间均存在一定差异。相较于利用全可调𬌗架参数，利用下颌运动轨迹及动态颌位关系设计修复体咬合面能更有效去除咬合干扰。

关键词: 全可调𬌗架, 下颌运动轨迹, 动态颌位关系, 计算机辅助设计, 咬合面

Abstract:

Objective This study aimed to compare the accuracy of trajectory-based personalized parameters from a fully adjustable articulator, mandibular movement trajectories, and dynamic jaw relationships. These components were evaluated to guide the design of a mandibular first molar prosthesis. The occlusal surface of the prosthesis was digitally designed through model experiments. Methods A total of 12 volunteers (4 males and 8 females) meeting the inclusion criteria were recruited, with a mean age of 29.5 years. The 3Shape Trios 3 intraoral scanner was used to obtain the ma-xillary and mandibular three-dimensional dental models of the subjects. It was also utilized to apply the patient-specific motion function for capturing the dynamic jaw relationships during protrusive, left lateral, and right lateral movements. The Zebris JMA Optic and ModjawTM mandibular movement analysis systems were also used to similarly capture the mandibular movement trajectories during the protrusive, left lateral, and right lateral movements of the subjects. Perso-nalized parameters corresponding to the fully adjustable articulator were obtained based on the mandibular movement trajectories recorded by the Zebris JMA Optic system. The mandibular first molar in the original model was virtually prepared following the occlusal veneer tooth preparation standard using reverse engineering software to obtain the mandibular working model. The occlusal surfaces of the occlusal veneers for the mandibular first molar were digitally designed with the help of fully adjustable articulator parameters (Articulator group), mandibular movement trajectories (JMA group, Modjaw group), and dynamic jaw relationships (PSM group) in the prosthetic design software. The occlusal surface morphology of the prosthesis designed by different methods was analyzed for deviation with the occlusal surface morphology of the original natural tooth of the subjects through reverse engineering software. The occlusal surface accuracy of the prosthesis designed by different methods was compared using several metrological indicators. Results The intergroup differences in average positive deviation among the Articulator, JMA, Modjaw, and PSM groups were not statistically significant (P>0.05). Meanwhile, the intergroup differences in average negative deviation, average de-viation, and root mean square were statistically significant (P<0.05). The average negative deviation in the Articulator group (-96.2±15.8) μm was greater than that in the JMA group (-160.1±44.4) μm, the Modjaw group (-141.6±33.2) μm, and the PSM group (-233.6±28.5) μm. The average deviation in the Articulator group (172.5±113.0) μm was greater than that in the JMA group (19.2±132.6) μm, the Modjaw group (70.3±121.3) μm, and the PSM group (-66.8±129.1) μm. Notably, the difference was statistically significant (P<0.05). Conclusion The occlusal surface morphology of the mandibular first molar prosthesis designed with the trajectory-based personalized parameters from a fully adjustable articulator, mandibular movement trajectories, and dynamic jaw relationships differed from the occlusal surface morphology of the original natural tooth. Compared with the fully adjustable articulator parameters, the occlusal surface of the prosthesis designed with mandibular movement trajectories and dynamic jaw relationships were more effective in removing occlusal interference.

Key words: fully adjustable articulator, mandibular movement trajectory, dynamic jaw relationship, computer-aided design, occlusal surface

中图分类号: 

  • R783

图 1

PSM的下颌运动幅度A：前伸运动幅度；B：左侧方运动幅度；C：右侧方运动幅度。"

图 2

下颌第一磨牙虚拟预备模型的构建A：原始天然牙列模型；B：46牙虚拟预备后的工作模型。"

图 3

不同数字化方法设计46牙??贴面修复体咬合面的流程"

图 4

参考区域与测试区域的获取A：46天然牙参考区域；B：提取参考区域的边界，向内均匀延伸0.5 mm，得到投影曲线；C：投影到??贴面上获得测试区域。"

图 5

4种方法设计??贴面与天然牙咬合面的三维形态偏差A：Articulator组；B：JMA组；C：Modjaw组；D：PSM组；色谱图显示不同方法设计的修复体与天然牙咬合面之间的偏差，绿色区域表示偏差在容许范围内（-100~100 μm）；红色区域表示修复体高于天然牙咬合面100 μm以上，蓝色区域表示修复体低于天然牙咬合面100 μm以上。"

表 1

Articulator组、JMA组、Modjaw组和PSM组修复体与天然牙咬合面比较的测量学指标结果 (μm)"

组别+AVG-AVGAVGRMS
Articulator249.1（117.2）-96.2±15.8172.5±113.0279.2（137.6）
JMA210.4（163.2）-160.1±44.419.2±132.6247.3（132.3）
Modjaw225.2（137.2）-141.6±33.270.3±121.3239.7（114.7）
PSM199.1（177.5）-233.6±28.5-66.8±129.1267.6（69.3）

图 6

Articulator组、JMA组、Modjaw组和PSM组组间两两比较A：-AVG指标4组间两两比较；B：AVG指标4组间两两比较；C：RMS指标4组间两两比较；***P<0.001，P值经过Bonferroni法校正。"

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