中国实用口腔科杂志

中国实用口腔科杂志

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基于口内扫描的三维数字化牙列模型咬合匹配评价分析

陈思涵1，苏庭舒1，阿地力江·依米提2，陈宁馨1，孙健1   

  1. 1. 上海交通大学医学院附属第九人民医院口腔修复科，上海  200011；2. 喀什地区第二人民医院口腔科，新疆  喀什 844000
  • 出版日期:2019-07-15 发布日期:2019-08-28
  • 基金资助:

    上海高校高峰高原学科建设项目；新疆维吾尔自治区自然科学基金（2016D01C096）；上海交通大学医学院大学生创新性试验国家级项目（1117502）

  • Online:2019-07-15 Published:2019-08-28

摘要：

目的    通过评价咬合接触面积及咬合接触点的分布，分析3个品牌口内扫描仪扫描牙列模型颊侧部分获取数字化咬合记录的可靠性。方法    使用3个品牌口内扫描仪（TRIOS、CS3600、CEREC Omnicam）分别扫描10副上下颌牙列模型后，通过扫描颊侧部分获得具有牙尖交错位三维空间位置关系的上下颌牙列数字化模型，以口外扫描仓获得的数字化模型为对照组，应用逆向工程软件的偏差分析功能显示下颌牙列模型上的咬合接触图像，测量上下颌间的咬合接触面积、咬合接触点的分布，并运用SAS统计学软件比较3个品牌口内扫描仪的咬合关系精确度。结果　全牙列咬合接触面积：TRIOS组为（15.160 ± 8.145）mm2，CEREC组为（13.153 ± 5.080）mm2，CS3600组为（27.509 ± 20.847）mm2，对照组为（23.194 ± 18.194）mm2；3个口内扫描仪组分别与对照组比较，差异均无统计学意义（P > 0.05）；CS3600组分别与TRIOS组和CEREC组比较，差异均有统计学意义（均P < 0.05）；而TRIOS组与CEREC组之间的差异无统计学意义（P > 0.05）。咬合接触面积分布统计图显示，3个品牌口内扫描仪所得的面积分布趋势基本相同，咬合接触面积磨牙区＞前磨牙区＞前牙区。咬合接触点分布统计图显示，3个品牌口内扫描仪全牙列咬合接触点分布呈左右对称，接触点数少于对照组；位于中央窝和边缘嵴处的接触点在口内扫描仪与对照组之间出现的重复率较高。结论    3个品牌口内扫描仪通过颊侧扫描记录上下颌位置关系，得到数字化咬合记录。在全牙列咬合接触面积方面，3个口内扫描仪均与口外扫描仓无明显差异；咬合接触面积的主要差异在于磨牙区，TRIOS和CEREC Omnicam 相比CS3600的磨牙区咬合接触面积更接近口外扫描仓。咬合接触点位于中央窝和边缘嵴处记录的准确性要高于颊舌尖斜面。

关键词: 口内扫描仪, 数字化印模, 颊侧扫描, 咬合接触

Abstract:

Objective    To evaluate the digital static interocclusal registration of three intraoral scanning systems using the buccal bite scan function by comparing the contact area and distribution of occlusal contacts between the digital models. Methods    The same 10 sets of maxillary and mandibular casts were mounted to a intercuspal position. The articulated models were digitized with an extraoral scanner and with three intraoral scanners，which located the mandibular and maxillary cast in a 3-dimensional（3D）spatial position by the buccal bite scan function. A reverse engineer software was used to analyze the occlusal contact area and the distribution in individual teeth. SAS was used to compare the precision of digital interocclusal registration between three intraoral scanners. Results    The general occlusal contact area was （23.194 ± 18.194）mm2 for controll group，（15.160 ± 8.145）mm2 for TRIOS group，（13.153 ± 5.080）mm2 for CEREC group， and（27.509 ± 20.847）mm2 for CS3600 group. The results showed no significant difference between controll group and the three test groups（P > 0.05）. The difference between CS3600 group and TRIOS or CEREC group was statistically significant（P < 0.05）. There was no significant difference between TRIOS group and CEREC group（P > 0.05）. The statistics of occlusal area showed that the area distribution trend of three intraoral scanners was basically the same. The occlusion contact distribution of the three intraoral scanners was symmetrical，and the number of contact points was fewer than that of the control group. Conclusion    Three intraoral scanners record mandible-maxilla relationship by buccal bite scan，and get the digital occlusion record. There is no significant difference in occlusal contact area of complete dentition between the three intraoral scanners and the extraoral scanner. The main difference of occlusal contact area is the molar area，and TRIOS and CEREC Omnicam show closer performance to the extraoral scanner than CS3600. The accuracy of recording occlusal contact points at the central fossa and marginal ridge is higher than that of buccal-tongue tip slope.

Key words: intraoral scanner, digital impression, buccal bite scan, occlusal contact