Bonnet Guillaume, Batisse Cindy, Bessadet Marion, Nicolas Emmanuel, Veyrune Jean-Luc
Université Clermont Auvergne, CROC, F-63000, Clermont-Ferrand, France.
CHU Clermont-Ferrand, Service d'Odontologie, F-63003, Clermont-Ferrand, France.
BMC Oral Health. 2017 Dec 20;17(1):155. doi: 10.1186/s12903-017-0440-z.
Historically, the complete removable denture is the last prosthetic procedure to switch to digital techniques whose advantages are mainly observed in the laboratory stages; however, it is not possible to measure the depressibility of the oral mucosa using optical cameras, thus conventional impression techniques are still necessary. This article describes the clinical and laboratory procedure and practitioners appraisal of the first fifteen digitally designed complete removable dental prostheses.
Several systems are now available including the Wieland® Digital Denture® which offers a complete procedure. This system is composed of a five axis-milling machine combined with a laboratory scanner and a design software application. Fifteen rehabilitations were carried out using the Wieland® system.
The practitioner's role is simplified by intraoral recording with a central point and a reduced number of sessions. The prosthesis laboratory requires considerable investment in learning and equipment, making it possible to obtain ideal mounting assemblies in accordance with the occluso-prosthetic concept of bilateral balanced occlusion. The absence of polymerization and therefore of base deformation risks reduce the equilibration step. Finally, the creation of templates as an alternative to the assembly of teeth on wax makes it possible to functionally validate (masticatory and phonatory) the future dentures. However, this procedure still presented some limitations in terms of scanning and software scope of applications.
Digital denture design software is relatively efficient and helps to standardize clinical results. However, to this date, improvements of the software are still required for a routine use.
从历史角度来看，全口义齿是最后一种转向数字技术的修复方法，数字技术的优势主要体现在实验室阶段；然而，使用光学相机无法测量口腔黏膜的可压性，因此传统印模技术仍然是必要的。本文描述了前15例数字化设计的全口义齿的临床和实验室操作过程以及从业者的评价。
现在有几种系统可供使用，包括提供完整操作流程的威兰德数字义齿系统。该系统由一台五轴铣床、一台实验室扫描仪和一个设计软件应用程序组成。使用威兰德系统进行了15例修复。
通过中心点的口内记录和减少就诊次数简化了从业者的工作。义齿制作实验室需要在学习和设备方面进行大量投资，从而能够根据双侧平衡咬合的咬合修复概念获得理想的上架组件。不存在聚合反应，因此也不存在基托变形风险，这减少了平衡步骤。最后，创建模板作为在蜡上组装牙齿的替代方法，使得能够在功能上验证（咀嚼和发声）未来的义齿。然而，该操作在扫描和软件应用范围方面仍然存在一些局限性。
数字义齿设计软件相对高效，并有助于使临床结果标准化。然而，迄今为止，仍需要对软件进行改进以便常规使用。
