中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (5): 542-549.DOI: 10.19538/j.kq.2024.05.007

• 论著 • 上一篇    下一篇

数字化微笑设计与美学预评估临时修复技术在前牙瓷贴面修复中的应用效果研究

谢慧心，张    云，张桂荣   

  1. 沈阳市口腔医院修复二科，辽宁 沈阳 110002
  • 出版日期:2024-09-30 发布日期:2024-09-30
  • 基金资助:
    辽宁省“兴辽英才”计划项目（XLYC1902073）；沈阳市科技计划项目（23-408-3-02；20-205-4-070）

  • Online:2024-09-30 Published:2024-09-30

摘要： 目的    比较应用数字化微笑设计（DSD）与美学预评估临时修复（APT）技术制作的瓷贴面与常规方法制作的瓷贴面在前牙美学修复中的临床效果。方法    选取2020年6月至2021年12月于沈阳市口腔医院修复二科行上前牙瓷贴面修复患者43例（90颗修复体），采用随机数字表法分为研究组（22例，46颗修复体）与对照组（21例，44颗修复体）。研究组采用DSD结合APT制作瓷贴面修复上前牙，对照组采用常规方法制作瓷贴面修复上前牙。比较2组每单位修复体完成时间，采用视觉模拟量表（VAS）分析患者满意度，采用改良粉白美学评分（PES/WES）体系评价患者牙齿、软组织的美学效果，采用改良美国公共卫生署（USPHS）评价标准分析修复体的临床效果。结果    研究组每单位修复体完成时间为（26.36 ± 5.69）min，其短于对照组［（31.00 ± 6.09）min］，差异有统计学意义（t = -2.581，P = 0.014）。研究组患者对修复体外形、舒适度、微笑效果的VAS评分高于对照组，差异均有统计学意义（均P < 0.05）；2组患者对修复体颜色的VAS评分比较，差异无统计学意义（P > 0.05）。修复前2组各项WES、PES比较，差异均无统计学意义（均P > 0.05）。修复后2周，研究组WES中牙齿形态、边缘轮廓评分高于对照组，PES中牙龈缘水平、软组织轮廓评分高于对照组，差异均有统计学意义（均P < 0.05）；其他项目评分组间比较，差异均无统计学意义（均P > 0.05）。改良USPHS评价结果显示，修复后2周，研究组基牙敏感度优于对照组，差异有统计学意义（P < 0.05）；2组修复体的完整性、边缘适合性、颜色匹配度、牙龈健康度比较，差异均无统计学意义（均P > 0.05）。修复后6个月，2组修复体各项评价指标比较，差异均无统计学意义（均P > 0.05）。结论  应用DSD与APT行前牙瓷贴面修复时，能够获得良好的牙齿及软组织美学效果；与常规方法比较，其可缩短椅旁戴牙时间，降低牙体预备后的敏感度，并提升患者治疗满意度。

关键词: 数字化微笑设计, 美学预评估临时修复, 瓷贴面, 美学修复

Abstract: Objective    To compare the clinical effect of porcerlain laminate veneers by digital smile design（DSD）and aesthetic pre-evaluation temporary（APT）technology with that by conventional method. Methods    This study involved 43 patients（90 restorations）who visited 2nd Department of Prosthodontics，Stomatology Hospital of Shenyang from June 2020 to December 2021. Totally 43 patients were randomly divided into the research group（22 patients，46 restorations）and the control group（21 patients，44 restorations）. Veneers in the research group were produced by DSD and APT technology，while in the control group veneers were produced by conventional technology. Compare the completion time of each restoration between the two groups. Patients′ satisfaction was analysed by visual analogue scale（VAS）. The aesthetic effect of teeth and soft tissues was assessed according to the modified pink esthetic score/white esthetic score（PES/WES）. Clinical effect of restorations was assessed according to the modified assessment criteria of the United States Public Health Service（USPHS）. Results    The completion time of each restoration in the research group［（26.36 ± 5.69）min］ was lower than that in the control group［（31.00 ± 6.09）min］，with significant differences（t = -2.581，P = 0.014）. The research group restoration achieved higher VAS than the control group in terms of shape，comfort degree and smile effect（P < 0.05），while there was no significant difference in the VAS of color between the two groups（P > 0.05）. Before the restoration，there were no significant differences in any aspect of PES/WES between the 2 groups. Two weeks after the treatment，the research group achieved higher score than the control group in the aspect of tooth shape and contour according to WES，as while as gingival level and soft tissue contour according to PES（P < 0.05）. There were no significant differences between two groups in other aspects（P > 0.05）. According to the modified USPHS standard，the research group achieved superior effect in tooth sensitivity than the control group at two weeks after treatment（P < 0.05），while there were no significant differences between the two groups in the completeness，margin adaptability，color matching or gingival health（P > 0.05）；at six months after treatment，there were no statistical differences between the two groups in any assessment items（P > 0.05）. Conclusion    The porcerlain laminate veneers produced by DSD and APT technology for anterior teeth restoration can achieve excellent esthetic effect in teeth and soft tissues，which can lower completion time and tooth sensitivity after teeth preparation compared with conventional technology，and promote patients′ satisfaction.

Key words: digital smile design, aesthetic pre-evaluation temporary, porcerlain laminate veneer, aesthetic prosthodontics