Garino Francesco, Garino G Battista
Medico Chirurgo.
Prog Orthod. 2004;5(2):248-58.
the introduction of digital study models in the orthodontic practice changed the traditional stone gipsotec to a virtual gipsotec and the orthodontist has the possibility to see, immediately on the computer, this basic analysis with a great reduction of space and time. The aim of this study is to extend the use of digital models to the occlusal virtual set-up in 3D and have the orthodontist simulate and visualize the resulting occlusion from a suggested treatment plan for the malocclusion.
a case is presented where the treatment plan involvers extractions. The malocclusion is a Class II division 1 in the permanent dentition where an extraction treatment of 1.4, 2.4, 3.5 et 4.5 is planned: the final result shows the new occlusal relationship with proper anchorage management of the extraction spaces. From the primary silicon impression, a digital model is obtained followed by the virtual set up according the prescription of the treatment plan. More digital treatment objectives can be performed for the same malocclusion from the primary digital models, according to different treatment plans and the resulting occlusion visualized.
the basic principle for the virtual occlusal set-up is the straight-wire system with the final position of the teeth resulting both from the bracket prescription and the final rectangular wire in a full slot engagement.
the resulting dental arches show a correct arch form, arch coordination and a proper dental intercuspation. The results coming from different virtual simulations are analyzed; all these simulations need only one pair of impressions. Limits of this virtual method are that it can be used only in full permanent dentition and for cases of dento-alveolar or dento-dental discrepancy.
正畸临床中数字研究模型的引入将传统的石膏模型转变为虚拟模型,正畸医生能够在计算机上即时进行这种基本分析,大大减少了空间和时间。本研究的目的是将数字模型的应用扩展到三维咬合虚拟排牙,并让正畸医生模拟和可视化针对错牙合畸形的建议治疗方案所产生的咬合结果。
介绍一个治疗方案涉及拔牙的病例。该错牙合畸形为恒牙列安氏II类1分类,计划拔除1.4、2.4、3.5和4.5:最终结果显示了新的咬合关系以及拔牙间隙的适当支抗管理。从初次硅橡胶印模获取数字模型,然后根据治疗方案的要求进行虚拟排牙。对于同一错牙合畸形,根据不同的治疗方案,可以从初次数字模型执行更多的数字治疗目标,并可视化产生的咬合结果。
虚拟咬合排牙的基本原理是直丝弓系统,牙齿的最终位置由托槽处方和完全入槽的最终矩形弓丝共同决定。
所得牙弓显示出正确的牙弓形态、牙弓协调性和适当的牙尖交错关系。分析了来自不同虚拟模拟的结果;所有这些模拟仅需要一副印模。这种虚拟方法的局限性在于它仅适用于恒牙列完全萌出的情况以及牙牙槽或牙牙之间存在差异的病例。