双约束分体式正畸微螺钉导板的数字化设计与制作方法

doi:10.7518/hxkq.2025.2024403

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (4): 603-612.doi: 10.7518/hxkq.2025.2024403

• 临床新技术 • 上一篇

双约束分体式正畸微螺钉导板的数字化设计与制作方法

杜欣¹^,²(), 温奥楠¹, 高梓翔¹, 李志华², 张晟², 王勇¹(), 赵一姣¹^,³()

^1.北京大学口腔医学院·口腔医院数字化研究中心国家口腔医学中心国家口腔疾病临床医学研究中心口腔生物材料和数字诊疗装备国家工程研究中心国家卫生健康委口腔数字医学重点实验室口腔数字医学北京市重点实验室，北京 100081
^2.南昌大学附属口腔医院口腔疾病江西省重点实验室江西省口腔疾病临床医学研究中心，南昌 330006
^3.北京大学医学部医学技术研究院，北京 100191

收稿日期:2024-11-04 修回日期:2025-03-15 出版日期:2025-08-01 发布日期:2025-08-29
通讯作者: 王勇,赵一姣 E-mail:158262045@qq.com;kqcadc@bjmu.edu.cn;kqcadcs@bjmu.edu.cn
作者简介:杜欣，住院医师，硕士，E-mail：158262045@qq.com

Digital design and manufacturing method of double constrained split guide for orthodontic miniscrew implantation

Du Xin¹^,²(), Wen Aonan¹, Gao Zixiang¹, Li Zhihua², Zhang Sheng², Wang Yong¹(), Zhao Yijiao¹^,³()

^1.Peking University School and Hospital of Stomatology, Center of Digital Dentistry & National Center for Stomato-logy & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & NHC Key Laboratory of Digital Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
^2.The Affiliated Stomatological Hospital, Nanchang University & Jiangxi Provincial Key Laboratory of Oral Diseases & Jiangxi Provincial Clinical Research Center for Oral Diseases, Nanchang 330006, China
^3.Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China

Received:2024-11-04 Revised:2025-03-15 Online:2025-08-01 Published:2025-08-29
Contact: Wang Yong,Zhao Yijiao E-mail:158262045@qq.com;kqcadc@bjmu.edu.cn;kqcadcs@bjmu.edu.cn

摘要/Abstract

摘要：

本研究探索了一种新型双约束分体式正畸微螺钉导板的数字化设计及制作方法，旨在提高临床微螺钉植入的准确性和安全性，减少相关并发症。研究选取1例需行微螺钉植入术的患者，利用锥形束CT（CBCT）和口内扫描获取数据，通过Mimics 24.0、Geomagic wrap 2021和Materialise magics 21.0等软件进行三维重建、模型整合及导板设计，构建包含钉孔导轨和植入杆导轨的双约束分体式导板，并经金属激光三维打印。模型和口内试戴结果显示，该导板就位良好、稳定性佳，术后CBCT验证微螺钉植入部位与术前设计方案基本一致，未发生相关并发症。该双约束分体式正畸微螺钉导板为临床微螺钉植入提供了一种精确、安全的数字化解决方案。

关键词: 计算机辅助设计, 手术定位导板, 微螺钉种植体, 3D打印

Abstract:

This study explored a novel digital design and fabrication method for a double constrained split orthodontic miniscrew guide to improve the accuracy and safety of clinical miniscrew implantation and reduce related complications. A patient requiring miniscrew implantation was selected, and data were acquired using cone beam computed tomography (CBCT) and intraoral optical scanning. For the construction of a double constrained split guide including a screw-hole guide and an insertion rod guide, different types of software such as Mimics 24.0, Geomagic wrap 2021, and Materialise magics 21.0 were utilized for 3D reconstruction, model integration, and guide design. The guide was then fabricated via laser metal 3D printing. Model and intraoral try-in results demonstrated that the guide fitted well and was stable. Postoperative CBCT verified that the final miniscrew implantation site was consistent with the preoperative design, and no related complications occurred. This double constrained split orthodontic miniscrew guide provides a precise and safe digital solution for clinical miniscrew implantation.

Key words: computer aided design, surgical positioning guide, miniscrew implant, 3D printing

中图分类号:

R783.5

杜欣, 温奥楠, 高梓翔, 李志华, 张晟, 王勇, 赵一姣. 双约束分体式正畸微螺钉导板的数字化设计与制作方法[J]. 华西口腔医学杂志, 2025, 43(4): 603-612.

Du Xin, Wen Aonan, Gao Zixiang, Li Zhihua, Zhang Sheng, Wang Yong, Zhao Yijiao. Digital design and manufacturing method of double constrained split guide for orthodontic miniscrew implantation[J]. West China Journal of Stomatology, 2025, 43(4): 603-612.

图/表 12

图 1

图 2

图 3

图 4

图 5

图 6

图 7

图 8

图 9

图 10

图 11

图 12

参考文献 17

[1]	Imburgia M, Logozzo S, Hauschild U, et al. Accuracy of four intraoral scanners in oral implantology: a comparative in vitro study[J]. BMC Oral Health, 2017, 17(1): 92.
[2]	Tepedino M, Masedu F, Chimenti C. Comparative evaluation of insertion torque and mechanical stability for self-tapping and self-drilling orthodontic miniscrews—an in vitro study[J]. Head Face Med, 2017, 13(1): 10.
[3]	Mohammed H, Wafaie K, Rizk MZ, et al. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis[J]. Prog Orthod, 2018, 19(1): 36.
[4]	Murugesan A, Sivakumar A. Comparison of bone thickness in infrazygomatic crest area at various miniscrew insertion angles in Dravidian population—A cone beam computed tomography study[J]. Int Orthod, 2020, 18(1): 105-114.
[5]	仇玲玲, 厉松, 白玉兴. 基于锥形束CT的正畸种植体导板设计及其引导下种植体植入安全性和稳定性的初步评价[J]. 中华口腔医学杂志, 2016, 51(6): 336-340.
	Qiu LL, Li S, Bai YX. Preliminary safety and stability assessment of orthodontic miniscrew implantation gui-ded by surgical template based on cone-beam CT images[J]. Chin J Stomatol, 2016, 51(6): 336-340.
[6]	Estelita S, Janson G, Chiqueto K, et al. Predictable drill-free screw positioning with a graduated 3-dimensional radiographic-surgical guide: a preliminary report[J]. Am J Orthod Dentofacial Orthop, 2009, 136(5): 722-735.
[7]	张永清, 陈昕, 闫寒松, 等. 正畸支抗种植体定位尺的研制和应用[J]. 口腔医学研究, 2006, 22(4): 459.
	Zhang YQ, Chen X, Yan HS, et al. Development and application of orthodontic anchorage implant positioning ruler[J]. J Oral Sci Res, 2006, 22(4): 459.
[8]	王晓波, 张梦洁, 孙应明, 等. 正畸微型种植体支抗的三维导向植入研究[J]. 现代口腔医学杂志, 2011, 25(4): 261-264.
	Wang XB, Zhang MJ, Sun YM, et al. Study on three-dimensional guided orthodontic micro-implant anchorage[J]. J Modern Stomatol, 2011, 25(4): 261-264.
[9]	陈妍曲, 唐敏, 黄旋平, 等. 高精度三维整合牙颌模型个体化微种植体手术导板的计算机辅助设计与制作[J]. 中国组织工程研究, 2018, 22(10): 1529-1533.
	Chen YQ, Tang M, Huang XP, et al. The computer-aided design and manufacturing of individualized miniscrew surgical guides based on a high-precision three-dimensional integrated digital maxillodental model[J]. Chin J Tis Eng Res, 2018, 22(10): 1529-1533.
[10]	Liu H, Liu DX, Wang G, et al. Accuracy of surgical positioning of orthodontic miniscrews with a computer-ai-ded design and manufacturing template[J]. Am J Orthod Dentofacial Orthop, 2010, 137(6): 728.e1-728.e10.
[11]	Endo T, Uchikura K, Ishida K, et al. Thresholds for cli-nically significant tooth-size discrepancy[J]. Angle Orthod, 2009, 79(4): 740-746.
[12]	刘静. 口内扫描仪全牙列扫描精度及不同操作者间扫描精度差异的研究[D]. 济南: 山东大学, 2017.
	Liu J. Accuracy of full arch scans with intraoral scanner and accuracy of scan results between examiners[D]. Jinan: Shandong University, 2017.
[13]	Sivamurthy G, Sundari S. Stress distribution patterns at mini-implant site during retraction and intrusion-a three-dimensional finite element study[J]. Prog Orthod, 2016, 17: 4.
[14]	武明彤, 唐素霞, 彭玲燕, 等. 仿真头颅模型口内和手持牙颌模型条件下四种口内扫描仪全牙弓扫描时间和精度的对比研究[J]. 中华口腔医学杂志, 2021, 56(6): 570-575.
	Wu MT, Tang SX, Peng LY, et al. Scan time and accuracy of full-arch scans with intraoral scanners: a comparative study on conditions of the intraoral head-simulator and the hand-held model[J]. Chin J Stomatol, 2021, 56(6): 570-575.
[15]	Favero R, Volpato A, Francesco M, et al. Accuracy of 3D digital modeling of dental arches[J]. Dental Press J Orthod, 2019, 24(1): 38e1-38e7.
[16]	汤槟晖, 徐婷, 孙志丹, 等. 金属激光三维打印技术研究现状及其发展趋势[J]. 材料保护, 2020, 53(6): 132-138.
	Tang BH, Xu T, Sun ZD, et al. Research status and deve-lopment trend of metal laser three-dimensional printing technology[J]. Mater Prot, 2020, 53(6): 132-138.
[17]	周庆军, 严振宇, 韩旭, 等. 激光熔化沉积TC11钛合金的组织与力学性能[J]. 中国激光, 2018, 45(11): 1102005.
	Zhou QJ, Yan ZY, Han X, et al. Microstructure and mechanical properties of laser melting deposition TC11 titanium alloy[J]. Chin J Laser, 2018, 45(11): 1102005.

双约束分体式正畸微螺钉导板的数字化设计与制作方法

Digital design and manufacturing method of double constrained split guide for orthodontic miniscrew implantation

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 12

参考文献 17

相关文章 15

编辑推荐

Metrics

本文评价

[1]	赵鹏宇, 陈岗, 程熠, 王超, 陈丹, 黄海涛. 3D打印个性化钛网辅助应用于牙槽骨缺损修复的临床观察及组织学分析[J]. 华西口腔医学杂志, 2025, 43(4): 592-602.
[2]	林保欣, 陈小瑄, 李如意, 万乾炳, 裴锡波. 浆料配比对3D打印牙科二硅酸锂陶瓷的微观结构和性能的影响[J]. 华西口腔医学杂志, 2025, 43(2): 175-182.
[3]	徐英新. 通过集中数字化印模提高临床效率的横断面研究[J]. 华西口腔医学杂志, 2025, 43(1): 63-67.
[4]	赵双元, 李成焱, 张壮. 口腔颌面部混合现实动态追踪技术数字化模型的应用基础研究[J]. 华西口腔医学杂志, 2024, 42(6): 787-794.
[5]	靳能皓, 乔波, 朱亮, 孟凡皓, 林权泉, 李粮博, 邢乐君, 赵睿, 张海钟. 口内扫描配准种植机器人在种植牙手术中的应用[J]. 华西口腔医学杂志, 2024, 42(6): 804-809.
[6]	王瑞斌, 胥铭章, 王兰, 郑紫阳, 邓云艺, 曾茂云, 袁玲玲, 彭培钊, 刘奇奇, 余科. 一种通用型牙种植导板在牙模上模拟后牙区种植的精度评价[J]. 华西口腔医学杂志, 2024, 42(3): 365-371.
[7]	秦庆钊, 胡嘉, 陈小贤, 石冰清, 高梓翔, 朱玉佳, 温奥楠, 王勇, 赵一姣. 儿童带环丝圈式间隙保持器的椅旁数字化设计与制作方法初探[J]. 华西口腔医学杂志, 2024, 42(2): 234-241.
[8]	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.
[9]	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.
[10]	李哲敏, 马雯洁, 杨淑然, 杨秋松, 王佳宁, 姚张顺, 林云红, 李星星. 核饰瓷厚度和树脂水门汀对玻璃陶瓷贴面乳光性能的影响[J]. 华西口腔医学杂志, 2022, 40(4): 403-408.
[11]	张玲阁, 李洁, 李继宏, 汤宏超, 刘玉学. 射频热凝术联合注射阿霉素治疗三叉神经下颌支痛的临床研究[J]. 华西口腔医学杂志, 2022, 40(4): 446-450.
[12]	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.
[13]	周永胜, 孙玉春, 王勇. 数字化全口义齿的临床应用和研究进展[J]. 华西口腔医学杂志, 2021, 39(1): 1-8.
[14]	郭家, 闵婕, 李娟, 于海洋. 目标修复体空间导向下保存龈下残根的正畸与修复联合治疗的数字化流程[J]. 华西口腔医学杂志, 2020, 38(5): 598-601.
[15]	席爽, 吴紫潇, 高翠翠, 孟雨晨, 裴丹丹, 逯宜. 牙合龈高度和隙料厚度对计算机辅助设计/计算机辅助制作全锆冠适合性与固位力的影响[J]. 华西口腔医学杂志, 2020, 38(3): 263-269.