中国实用口腔科杂志

中国实用口腔科杂志

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数字化3D打印技术在口腔舌侧正畸托槽粘接中应用研究

林    泽a，陈    军a，李    雪b   

  1. 武汉大学人民医院 a放射科，b口腔科，武汉 430060
  • 出版日期:2016-02-15 发布日期:2016-03-09

  • Online:2016-02-15 Published:2016-03-09

摘要：

目的    利用3D打印技术探索一种个性化、精密度更高、底板更吻合的舌侧托槽设计和直接制造技术，为正畸临床提供更好的技术支持。方法    收集2014年1月至2015年1月在武汉大学人民医院接受口腔正畸的患者40例，随机分为试验组与对照组，每组各20例。试验组患者通过CT 扫描获取牙模数据，导入医学图像处理软件Mimics对图像进行数据处理，经反求技术（镜像方法）转化成牙齿计算机辅助设计（CAD）模型；模拟牙齿移动，确定方案后用选区激光熔化快速成型口腔专用3D 打印设备制造个性化舌侧托槽粘接。对照组行常规口腔舌侧正畸托槽粘接。结果    6个月后复查，试验组个性化舌侧托槽临床远期效果为95%，对照组为75%，试验组显著高于对照组（P＜0.05）；试验组并发症发生率为5%，显著低于对照组的25%。结论    托槽粘接后底板和牙舌侧面的吻合程度的对比，运用3D打印技术制造的托槽明显吻合度高，粘接定位准确，操作简便，且从临床远期可行性来看，不容易脱落，大大简化了治疗程序。

关键词: 3D 打印, 反求工程技术, 舌侧正畸托槽, 个性化, 精密性

Abstract:

Objective    To explore a new type of lingual orthodontics design and direct manufacturing technology with 3D printing and to supply experiment evidence for clinical application. Methods    From January 2014 to January 2015，40 patients who received orthodontic treatment in our hospital were randomly divided into experiment group and control group，each with 20 cases；the control group received routine oral tongue side orthodontic brackets；the experiment group used a 3D printer to print the oral tongue side orthodontic bracket. For patients in the experiment group tooth-model data were obtained through CT scanning，and the data were put into Mimics software for post-processing，and then through reverse technology（mirror imaging），date were converted to the tooth computer aided design（CAD）model. The project was determined by modeling tooth movement and customized lingual bracket was manufactured by selective laser melting rapid prototyping oral special 3D printing device. Results    Clinical effective rate were 95% and 75% in experiment group and control group respectively after 6 months follow-up；the experiment group's was significantly higher than that of the control group（P < 0.05）. The complication rate was 5% in the experiment group and was significantly lower than that of the control group （25%）. Conclusion    The clinical application effect of the using 3D printing technology in manufacturing customized lingual bracket is satisfactory. When using 3D printing mathch degree is high and the bonding location is accurate. It's easy to operate，and from clinical long-term perspective，it is not easy to fall off and greatly simplifies the procedures.

Key words: 3D printing, reverse engineering, tongue side orthodontic bracket, individual, precision