目标修复体空间指导多学科联合治疗精准修复1例

doi:10.7518/hxkq.2022.05.016

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (5): 610-617.doi: 10.7518/hxkq.2022.05.016

• 临床技术改进 • 上一篇

目标修复体空间指导多学科联合治疗精准修复1例

杨雷宁¹(), 秦行林², 张静³, 韩晓鹏¹()

^1.滨州医学院附属烟台市口腔医院修复科，烟台 264000
^2.滨州医学院附属烟台市口腔医院正畸科，烟台 264000
^3.滨州医学院附属烟台市口腔医院修复工艺科，烟台 264000

收稿日期:2021-12-08 修回日期:2022-08-09 出版日期:2022-10-01 发布日期:2022-10-17
通讯作者: 韩晓鹏 E-mail:yangleining@fox-mail.com;hanxp8@sohu.com
作者简介:杨雷宁，副主任医师，硕士，E-mail：yangleining@fox-mail.com
基金资助:
2021年滨州医学院教学改革与研究项目(JYKTMS20-21071)

A case of precise prosthesis under the direction of target restoration space analysis after multidisciplinary combination therapy

Yang Leining¹(), Qin Hanglin², Zhang Jing³, Han Xiaopeng¹()

^1.Dept. of Prosthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical University, Yantai 264000, China
^2.Dept. of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical University, Yantai 264000, China
^3.Dept. of Restoration Technology, Yantai Stomatological Hospital Affiliated to Binzhou Medical University, Yantai 264000, China

Received:2021-12-08 Revised:2022-08-09 Online:2022-10-01 Published:2022-10-17
Contact: Han Xiaopeng E-mail:yangleining@fox-mail.com;hanxp8@sohu.com
Supported by:
2021 Teaching Reform and Research Project of Binzhou Medical University(JYKTMS2021071);Correspondence: Han Xiaopeng, E-mail: hanxp8@sohu.com

摘要/Abstract

摘要：

冠、桥修复需要对基牙进行定量调磨，如何更加精准地进行牙体的定量预备是微创修复追求的目标之一。本文报道1例上、下颌侧切牙先天缺失的病例，以目标修复体空间（TRS）为指导，在正畸、牙周多学科联合治疗后，制作个性化牙体预备数字化导板辅助精准牙体预备，完成固定桥修复，最终为患者恢复了上颌牙列的完整、美观和功能。该病例提示，在TRS指导下，牙体预备数字化导板能有效提高牙体预备的准确性。

关键词: 牙体预备, 目标修复体空间, 数字化导板, 多学科联合治疗, 精准

Abstract:

Quantitative grinding of abutment teeth is needed in crown and bridge restoration. Accurate quantitative preparation of teeth is one of the goals of minimally invasive restoration. In this paper, a case of congenital loss of upper and lower incisors was reported. Guided by the target restoration space (TRS), a personalized digital guide plate for tooth preparation was built to assist precise tooth preparation after the multidisciplinary combination therapy of orthodontic and periodontal teeth. Finally, the fixed bridge was prepared to meet the integrity, beauty, and function of the maxillary for the patient. In this case, the results suggest that the digital guide plate built under the guidance of TRS can be used to improve the accuracy of dental preparation.

Key words: tooth preparation, target restoration space, digital guide plate, multidisciplinary combination therapy, precise

中图分类号:

R 783.2

杨雷宁, 秦行林, 张静, 韩晓鹏. 目标修复体空间指导多学科联合治疗精准修复1例[J]. 华西口腔医学杂志, 2022, 40(5): 610-617.

Yang Leining, Qin Hanglin, Zhang Jing, Han Xiaopeng. A case of precise prosthesis under the direction of target restoration space analysis after multidisciplinary combination therapy[J]. West China Journal of Stomatology, 2022, 40(5): 610-617.

图/表 17

图 1

图 2

图 3

图 4

图 5

图 6

图 7

图 8

图 9

图 10

图 11

图 12

图 13

图 14

图 15

图 16

图 17

参考文献 27

1	周永胜. 口腔修复学[M]. 北京: 北京大学医学出版社, 2020: 35-36.
	Zhou YS. Prosthodontics[M]. Beijing: Peking University Medical Press, 2020: 35-36.
2	陈端婧, 李怡源, 李俊颖, 等. 一种显微精准定深孔牙体预备技术[J]. 华西口腔医学杂志, 2016, 34(3): 325-327.
	Chen DJ, Li YY, Li JY, et al. A precise tooth preparation technique assisted with quantitive bur and microscope[J]. West China J Stomatol, 2016, 34(3): 325-327.
3	张倩倩, 陈昕, 赵雨薇, 等. 3D打印在口腔美学修复中的应用[J]. 华西口腔医学杂志, 2018, 36(6): 656-661.
	Zhang QQ, Chen X, Zhao YW, et al. Application of 3D printing in aesthetic oral rehabilitation[J]. West China J Stomatol, 2018, 36(6): 656-661.
4	于海洋, 罗天. 目标修复体空间中的数量及数量关系在精准美学修复中的应用[J]. 华西口腔医学杂志, 2016, 34(3): 223-228.
	Yu HY, Luo T. Application of target restoration space quantity and quantitative relation in precise esthetic pro-sthodontics[J]. West China J Stomatol, 2016, 34(3): 223-228.
5	刘春煦, 高静, 赵雨薇, 等. 一种3D打印定深孔导板引导的精准牙体预备技术[J]. 华西口腔医学杂志, 2020, 38(3): 350-355.
	Liu CX, Gao J, Zhao YW, et al. Precise tooth preparation technique guided by 3D printing guide plate with quantitative hole[J]. West China J Stomatol, 2020, 38(3): 350-355.
6	Belser UC, Grütter L, Vailati F, et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores[J].J Perio-dontol, 2009, 80(1): 140-151.
7	Fürhauser R, Florescu D, Benesch T, et al. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005, 16(6): 639-644.
8	Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971[J]. Clin Oral Investing,2005, 9(4): 215-232.
9	罗天, 李俊颖, 于海洋. 制备高精度牙预备体肩台的临床路径和预备方法[J]. 华西口腔医学杂志, 2020, 38(6): 712-717.
	Luo T, Li JY, Yu HY, et al. Clinical pathway and preparation method of high-precision tooth shoulder platform[J]. West China J Stomatol, 2020, 38(6): 712-717.
10	于海洋, 李俊颖. 目标修复体空间的内涵、分析设计及临床转移实施[J]. 华西口腔医学杂志, 2015, 33(2): 111-114.
	Yu HY, Li JY. The concept, clinical design and transfer application of target restoration space[J]. West China J Stomatol, 2015, 33(2): 111-114.
11	于海洋. 关于牙体预备里的数字追问——从目测经验类比到数字引导[J]. 华西口腔医学杂志, 2021, 39(1): 9-19.
	Yu HY. Questions about the numerical value and quantitative data transfer of tooth preparation—from experien-ce guidance to digital guidance[J]. West China J Stomatol, 2021, 39(1): 9-19.
12	李忠义, 白鹤飞, 王勇, 等. 牙体预备定量引导技术的研究现状[J]. 中华口腔医学杂志, 2018, 53(2): 137-140.
	Li ZY, Bai HF, Wang Y, et al. Research status of tooth preparation quantitative guide technique[J]. Chin J Stomatol, 2018, 53(2): 137-140.
13	陈洪刚, 剡亚妹, 高婧. 3D打印在口腔种植学中的应用研究进展[J]. 实用口腔医学杂志, 2021, 37(3): 419-422.
	Chen HG, Yan YM, Gao J. Research progress on the application of 3D printing in oral implantology[J]. J Pract Stomatol, 2021, 37(3): 419-422.
14	花超超, 张荣和. 3D打印在口腔正畸临床诊疗中的应用进展[J]. 口腔医学研究, 2019, 35(9): 833-836.
	Hua CC, Zhang RH. Application of 3D printing technology in clinical diagnosis and treatment of orthodontics[J]. J Oral Sci Res, 2019, 35(9): 833-836.
15	赵会懂, 张玉杰, 焦晓燕, 等. 3D打印技术在口腔修复治疗中的应用进展[J]. 临床误诊误治, 2019, 32(10): 113-116.
	Zhao HD, Zhang YJ, Jiao XY, et al. Application progress of 3D printing technology in prosthodontic treatment[J]. Clin Misdiagn Misther, 2019, 32(10): 113-116.
16	刘华蔚, 李永锋, 母晓丹, 等. 口腔颌面外科手术三维打印系列导板的设计制作和临床应用[J]. 中华口腔医学杂志, 2021, 56(11): 1085-1091.
	Liu HW, Li YF, Mu XD, et al. Design and application of three-dimensional printing guide plate for oral and ma-xillofacial surgery[J]. Chin J Stomatol, 2021, 56(11): 1085-1091.
17	李玉姣, 钱飞, 张倩霞, 等. 3D打印在微创牙髓治疗中应用的研究进展[J]. 口腔疾病防治, 2021, 29(10): 716-720.
	Li YJ, Qian F, Zhang QX, et al. Research progress on 3D printing in minimally invasive endodontics[J]. J Prevent Treat Stomatolog Dis, 2021, 29(10): 716-720.
18	魏焱, 张晓欣, 许胡笛. 3D打印在口腔临床工作的应用[J]. 口腔医学研究, 2019, 35(4): 325-327.
	Wei Y, Zhang XX, Xu HD. Application of 3D printing in oral clinical work[J]. J Oral Sci Res, 2019, 35(4): 325-327.
19	任子龙, 周晨, 王忠山. 3D打印技术在口腔材料领域的研究进展[J]. 中国实用口腔科杂志, 2020, 13(9): 564-569.
	Ren ZL, Zhou C, Wang ZS. Research progress of 3D printing technology in the field of dental materials[J]. Chin J Pract Stomatol, 2020, 13(9): 564-569.
20	杜雪, 瞿方, 刘伟才. 三维虚拟牙科患者的建立及其在美学修复中的应用[J]. 国际口腔医学杂志, 2018, 45(6): 695-702.
	Du X, Qu F, Liu WC. Establishment of a three-dimensional virtual dental patient and its application in esthetic restoration[J]. Int J Stomatol, 2018, 45(6): 695-702.
21	Yu H, Zhao Y, Li J, et al. Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus[J]. Int J Oral Sci, 2019, 11(3): 31.
22	Li ZY, Bai HF, Zhao YJ, et al. 3D evaluation of accuracy of tooth preparation for laminate veneers assisted by rigid constraint guides printed by selective laser melting[J]. Chin J Dent Res, 2020, 23(3): 183-189.
23	Silva BPD, Stanley K, Gardee J. Laminate veneers: preplanning and treatment using digital guided tooth preparation[J]. J Esthet Restor Dent, 2020, 32(2): 150-160.
24	Gao J, He J, Fan L, et al. Accuracy of reduction depths of tooth preparation for porcelain laminate veneers assisted by different tooth preparation guides: an in vitro study[J]. J Prosthodont, 2022, 31(7): 593-600.
25	Luo T, Zhang J, Fan L, et al. A digital workflow with the virtual enamel evaluation and stereolithographic templa-te for accurate tooth preparation to conservatively manage a case of complex exogenous dental erosion[J]. J Esthet Restor Dent, 2022, 34(5): 733-740.
26	Gao J, Li J, Liu C, et al. A stereolithographic template for computer-assisted teeth preparation in dental esthetic ceramic veneer treatment[J]. J Esthet Restor Dent, 2020, 32(8): 763-769.
27	谭建国. 牙齿美学修复的美学分析与设计[J]. 中国实用口腔科杂志, 2011, 4(8): 449-450.
	Tan JG. Esthetic analysis and design in dental esthetic rehabilitation[J]. Chin J Pract Stomatol, 2011, 4(8): 449-450.

[1]	王旭东, 魏弘朴, 李彪. 从“经验外科”到“精准外科”——精准正颌外科体系的建立与临床应用[J]. 华西口腔医学杂志, 2023, 41(5): 491-501.
[2]	胡楠, 刘春煦, 高静, 解晨阳, 余嘉怡, 贾璐铭, 于海洋. 一种三维打印导板引导的同期种植与牙体预备技术[J]. 华西口腔医学杂志, 2023, 41(4): 483-490.
[3]	张隽婧, 张煜强, 范琳, 于海洋. 应用数字化流体树脂注射导板快速关闭正畸后前牙间隙1例[J]. 华西口腔医学杂志, 2023, 41(1): 114-122.
[4]	王映凯, 解晨阳, 张煜强, 张雅萌, 方婷露, 于海洋. 分置式可测量种植导板在多颗前牙即刻种植即刻修复中的应用[J]. 华西口腔医学杂志, 2022, 40(6): 731-739.
[5]	赵志河, 金作林, 白玉兴, 房兵, 白丁, 李巍然, 贺红, 胡敏, 刘月华, 陈莉莉, 宋锦璘, 曹阳, 李宇, 舒睿. 正畸牙移动核心科学问题：目标位、效率、精准度[J]. 华西口腔医学杂志, 2022, 40(4): 371-376.
[6]	贺锦秀, 高静, 刘春煦, 解晨阳, 余嘉怡, 于海洋. 一种序列3D打印导板引导的瓷贴面分区粘接技术[J]. 华西口腔医学杂志, 2022, 40(3): 365-369.
[7]	高羽轩, 汪鎏, 傅裕杰, 杨帆, 张岚, 黄定明. 数字化导板引导技术辅助微创治疗前牙钙化根管[J]. 华西口腔医学杂志, 2022, 40(1): 111-122.
[8]	卢嘉仪, 赵君仪, 高静, 于海洋. 1 312件单冠预备体数字化模型的关键预备质量指标的分析研究[J]. 华西口腔医学杂志, 2022, 40(1): 52-60.
[9]	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.
[10]	于海洋. 关于牙体预备里的数字追问——从目测经验类比到数字引导[J]. 华西口腔医学杂志, 2021, 39(1): 9-19.
[11]	罗天, 李俊颖, 于海洋. 制备高精度牙预备体肩台的临床路径和预备方法[J]. 华西口腔医学杂志, 2020, 38(6): 712-717.
[12]	刘春煦, 高静, 赵雨薇, 范琳, 贾璐铭, 胡楠, 梅子彧, 董博, 张倩倩, 于海洋. 一种3D打印定深孔导板引导的精准牙体预备技术[J]. 华西口腔医学杂志, 2020, 38(3): 350-355.
[13]	娄方芝, 张茂芮, 饶鹏程, 罗世洪, 唐梦莹, 肖金刚. 数字化导板在前牙美学区种植修复应用的精确度研究[J]. 华西口腔医学杂志, 2020, 38(2): 170-176.
[14]	贾璐铭,贺锦秀,卢嘉仪,余萍,郭家,范琳,刘春煦,于海洋. 一种实测实量引导植入位点的精准牙种植技术[J]. 华西口腔医学杂志, 2020, 38(1): 108-113.
[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.

目标修复体空间指导多学科联合治疗精准修复1例

A case of precise prosthesis under the direction of target restoration space analysis after multidisciplinary combination therapy

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 17

参考文献 27

相关文章 15

编辑推荐

Metrics

本文评价