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使用CAD/CAM技术制作的新型舌侧固位体:其定位精度评估

Novel lingual retainer created using CAD/CAM technology: evaluation of its positioning accuracy.

作者信息

Wolf M, Schumacher P, Jäger F, Wego J, Fritz U, Korbmacher-Steiner H, Jäger A, Schauseil M

机构信息

Department of Orthodontics, Dental Clinic, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany,

出版信息

J Orofac Orthop. 2015 Mar;76(2):164-74. doi: 10.1007/s00056-014-0279-8.

Abstract

OBJECTIVES

Permanent retention is currently the method of choice to stabilize orthodontic treatment results. Frequently, permanent retention schemes are adopted to prevent posttreatment changes in the esthetic zone of the anterior teeth. With increasingly prolonged times of intraoral device use, and retention to be provided in the maxilla despite limited space, the demands placed on well-planned and precise retainer positioning are becoming more exacting. The aim of the present study was to analyze the intraoral precision of lingual retainers made using computer-aided design and machining (CAD/CAM).

MATERIALS AND METHODS

A custom manufacturer (Retaintechnology; Cologne, Germany) employing innovative CAD/CAM technology was commissioned to fabricate 16 lingual retainers. Following intraoral insertion using the manufacturer's recommended transfer system, impressions of the intraoral situations were taken and scanned for digitization. On this basis, the intraoral retainer positions were compared to the preceding virtual setups by superimposition with the manufacturer's datasets. Three-dimensional processing software (Geomagic Qualify 2012; Geomagic) was used to analyze the retainers, based on a total of 80 interproximal sites, for deviations from their planned positions along the horizontal (x-), sagittal (y-), and vertical (z-) axes. These deviations of the achieved from the intended positions were considered clinically relevant if ≥ 0.5 mm and, based on this premise, were subjected to a t-test with statistical software (Prism; GraphPad).

RESULTS

The intraoral retainer positions were found to correlate closely with the preceding virtual setups (i.e., the positions as they had been planned by the custom manufacturer). Positional deviations were significantly less than 0.5 mm. They were very small in the horizontal and sagittal planes and moderately larger in the vertical plane.

CONCLUSION

Highly precise intraoral results may be achieved by transferring three-dimensional virtual setups for lingual retainers to the actual patients. This CAD/CAM strategy of making retainers can offer high predictability even in anatomically demanding regions and in the presence of limited space.

摘要

目的

永久保持是目前稳定正畸治疗效果的首选方法。通常采用永久保持方案来防止前牙美学区的治疗后变化。随着口腔内装置使用时间的延长,以及在上颌骨空间有限的情况下仍需进行保持,对精心规划和精确的保持器定位的要求越来越高。本研究的目的是分析使用计算机辅助设计和加工(CAD/CAM)制作的舌侧保持器在口腔内的精度。

材料与方法

委托一家采用创新CAD/CAM技术的定制制造商(Retaintechnology;德国科隆)制作16个舌侧保持器。使用制造商推荐的转移系统在口腔内插入后,获取口腔内情况的印模并进行扫描以进行数字化处理。在此基础上,通过与制造商的数据集叠加,将口腔内保持器的位置与先前的虚拟设置进行比较。使用三维处理软件(Geomagic Qualify 2012;Geomagic)基于总共80个邻间隙部位分析保持器沿水平(x轴)、矢状(y轴)和垂直(z轴)轴偏离其计划位置的情况。如果达到的位置与预期位置的偏差≥0.5mm,则认为这些偏差具有临床相关性,并在此前提下使用统计软件(Prism;GraphPad)进行t检验。

结果

发现口腔内保持器的位置与先前的虚拟设置密切相关(即定制制造商计划的位置)。位置偏差明显小于0.5mm。它们在水平和矢状平面上非常小,在垂直平面上稍大。

结论

通过将舌侧保持器的三维虚拟设置转移到实际患者身上,可以在口腔内获得高度精确的结果。这种CAD/CAM制作保持器的策略即使在解剖结构要求高的区域和空间有限的情况下也能提供高可预测性。

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