种植修复里的数字追问——从经验类比到数字引导

doi:10.7518/hxkq.2021.04.003

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (4): 386-397.doi: 10.7518/hxkq.2021.04.003

种植修复里的数字追问——从经验类比到数字引导

于海洋()

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院修复科，成都 610041

收稿日期:2020-10-22 修回日期:2021-03-20 出版日期:2021-08-01 发布日期:2021-08-10
通讯作者: 于海洋 E-mail:yhyang6812@scu.edu.cn
作者简介:于海洋，教授，博士，E-mail：yhyang6812@scu.edu.cn。教授、博士生导师、一级临床专家。擅长显微美学修复、数字种植修复等。现任中华口腔医学会修复专业委员会候任主任委员，口腔修复国家临床重点专科负责人，四川大学口腔医学技术专业负责人，修复Ⅱ科主任。国际牙医师学院院士，教育部新世纪优秀人才；四川省有突出贡献的专家；《华西口腔医学杂志》、Bone Research副主编。参与制订国家及行业标准6项；研究成果获教育部自然科学一等奖，教学成果获国家教学成果二等奖等。主编规划教材《口腔固定修复学》、《口腔医学美学》以及专著《数字引导式显微修复学》、《引导式精准植入术》、《口腔微距摄影速成》等29部。提出了目标修复体空间TRS数论、美学修复形-色-心三要素四维辩证论，发明了iTRS系列导板（备牙、种植、转移、粘接等）、定深孔显微牙体预备术、实测引导种植术、E-clasp等多项临床技术方案；研发的多项软件及医疗器械产品已经成功转化临床。
基金资助:
四川省科技计划(2020YFS0040)

The question about the numerical value and quantitative data transfer of implant prosthodontics—orom experience guidance to digital guidance

Yu Haiyang()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2020-10-22 Revised:2021-03-20 Online:2021-08-01 Published:2021-08-10
Contact: Yu Haiyang E-mail:yhyang6812@scu.edu.cn
Supported by:
Sichuan Science and Technology Program(2020YFS0040)

摘要/Abstract

摘要：

正确的种植位点设计和精准的临床实施是种植修复的基本临床技术。长期以来种植手术大多以徒手植入为主，位点的选择多依赖于术者长期经验的累积，这种经验类比逻辑引导下的种植位点选择，往往随着术者经验水平高低和偶然误差大小而发生偏差，极易产生不正确种植位点及其相关的并发症。与此不同，基于修复导向下的种植理念出现了采用数字引导和实测核查的数字化临床方案，其标志着精准的且可实测核查的引导式种植修复形成。而从数据测量的四要素构成要件看，数字化种植修复依赖的数值要求来源存疑、测量要素不全、数据真伪难辨。为了深刻理解数字化修复、引导式种植以及种植实测技术的演化，本文将对种植修复中的数值要求展开追问，并进行了初步论证，提出了针对正确位点和修复空间数值要求的全新可靠的实测和核查方法，以及依赖数字的新临床方案；并进一步探讨以经验类比为逻辑基础的当前主流种植修复技术基础无法有效支撑全程数字化种植修复的原委，为最终实现全程数字化种植修复提供新的逻辑认知基础。

关键词: 数字化种植修复, 实测引导技术, 导板, 目标修复体空间

Abstract:

The correct implant site design and placement are the basic clinical techniques that must be known for implant restoration. For a long time, most implants have been placed by free hands, and the choice of site is mostly dependent on the accumulation of long-term experience of the surgeon. The selection of implant site guided by this experience analogy logic is often based on the surgeon's level of experience,which often makes it very easy to produce complications related to the implant restoration of the incorrect site. In contrast, a clinical program using digital guidance and real-time measurable verification has emerged based on the restoration-oriented implantation concept, which marks the formation of an accurate, measurable and verifiable whole-process digital implant prototype. Furthermore, from the perspective of surveying, the numerical requirements that digital implant restoration relies on are actually incomplete to the four elements of measurement, which leading to the doubts about its authenticity. This article will question the numbers in implant restoration, and conduct a preliminary demonstration, and propose a new reliable actual measurement and verification method of the correct location and the numerical requirements of the restoration space and a new clinical program that relies on numbers from the perspective of the evolution of digital restoration, guided implantology and actual measurement technology. And this article further discusses the current mainstream implant restoration technology based on experience analogy which cannot effectively support the whole process of digital implant restoration and provides a new logical cognitive basis for the final realization of the entire process of digital implant restoration.

Key words: digital implant restoration, measuring guidance technology, guide, target restoration space

中图分类号:

R 783.3

于海洋. 种植修复里的数字追问——从经验类比到数字引导[J]. 华西口腔医学杂志, 2021, 39(4): 386-397.

Yu Haiyang. The question about the numerical value and quantitative data transfer of implant prosthodontics—orom experience guidance to digital guidance[J]. West China Journal of Stomatology, 2021, 39(4): 386-397.

图/表 5

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种植体数目	种植体直径	缺牙间隙近远中宽度
单颗	3 mm	6 mm
	4 mm	7~12 mm
	5 mm	11~13 mm
	6 mm	12~14 mm
多颗	-	≥15 mm

种植体颈部结构	种植位点骨嵴与邻牙CEJ的垂直间距	种植体植入深度
光滑颈部	≤3 mm（垂直方向无明显骨吸收）	光滑颈与粗糙面交界平面处位于骨下1 mm
	>3 mm（垂直方向存在明显骨吸收）	光滑颈与粗糙面交界平面处平齐骨平面
粗糙颈部	≤3 mm（垂直方向无明显骨吸收）	颈部上缘平面位于骨下1 mm
	>3 mm（垂直方向存在明显骨吸收）	颈部上缘平面平齐骨平面

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[15]	王晓华,刘艾芃,邓文正. 数字化导板在口腔种植中的研究进展[J]. 华西口腔医学杂志, 2020, 38(1): 95-100.

种植修复里的数字追问——从经验类比到数字引导

The question about the numerical value and quantitative data transfer of implant prosthodontics—orom experience guidance to digital guidance

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