北京大学学报（医学版）2018，Vol.50Issue(1)：78-84,7.DOI:10.3969/j.issn.1671-167X.2018.01.014
数字化正畸修复联合治疗设计在前牙美学重建中的应用
Application of digital design of orthodontic-prosthodontic multidisciplinary treatment plan in esthetic rehabilitation of anterior teeth
摘要
Abstract
Objective: To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation,in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Methods: Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors,including time,costs of treatment,each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. Results: The medians of scores of DP treatment plan and OP treatment plan were calculated and analyzed by IBM SPSS 20. The median of scores of DP treatment plan was 8.4,the minimum value was 6.9 and the maximum value was 9.3. The median of scores of OP treatment plan was 9. 0, the minimum value was 7.9 and the maximum value was 9. 6. The median of scores of OP was significantly higher than that of DP (Z=-3. 23,P <0.01). Finally,12 patients chose OP treatment plans and 8 patients chose DP treatment plans. Conclusion: For cases with complex esthetic problems in anterior teeth,a digital workflow can demonstrate final treatment outcome and help patients make suitable treatment decisions. In our study, the orthodontic-prosthodontic multidisciplinary treatment plan is feasible which can provide predictions of treatment outcome and improve esthetic outcome with patients' satisfaction.关键词
计算机辅助设计/正畸修复联合治疗/美学,牙科Key words
Computer-aided design/Orthodontic-prosthodontic treatment/Esthetics, dental分类
医药卫生引用本文复制引用
柳玉树,李峥,赵一姣,叶红强,周彦秋,胡文杰,刘云松,寻春雷,周永胜..数字化正畸修复联合治疗设计在前牙美学重建中的应用[J].北京大学学报（医学版）,2018,50(1):78-84,7.基金项目
首都卫生发展科研专项项目（首发2016-14101）、科技北京百名领军人才培养工程(Z171100001117169)和北京大学口腔医院新技术新疗法项目(PKUSSNCT-17A01)资助 （Z171100001117169）
Supported by the Capital Health Research and Development of Special (2016-1-4101)， the Project for Culturing Leading Talents in Scientific and Technological Innovation of Beijing (Z171100001117169) and the New Clinical Technology Program of Peking University Hospital and Stomatology (PKUSSNCT-17A01) （2016-1-4101）
