Peng L, Wang Z H, Sun Y C, Qu W, Han Y, Liang Y H
Department of Conservative Dentistry and Endodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Center for Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Oct 18;50(5):905-910.
To establish an apicoectomy guide template design and manufacturing method, based on multi-source data fusion, computer aided design (CAD) and fused deposition modeling (FDM). The feasibility of the guide template was preliminary evaluated by the in vitro model experiment.
An extracted upper anterior tooth, after root canal treatment, was optical scanned, after which the extracted upper anterior tooth was poured in an apicoectomy plaster model. Cone-beam computed tomography (CBCT) scanning of the apicoectomy plaster model was performed, after which optical scanning of the plaster model for apical resection surgery was carried out. All of the relevant CBCT and optical scanning data of the extracted upper anterior tooth and the apicoectomy plaster model were introduced into the Geomagic Studio 2012 software. The multi-source data fusion technology was used to virtually simulate the three-dimensional positional relationship of the extracted tooth, the dentition, the alveolar bone and the gingival, based on which, the three-dimensional design of the apicoectomy guide template was completed in the Geomagic Studio 2012 software. With the technology of fused deposition modeling, the apical resection surgical guide template was three-dimensionally printed with the material of polylactic acid (PLA). Under the guidance of the surgical guide template, the root apical resection was performed on the plaster model. After the apicoectomy, the extracted upper anterior tooth was taken off from the apicoectomy plaster model and then was given the optical scanning. The apical resection length and angle were calculated by the function of distance measurement and angle measurement, and the results were compared with the preset values.
The length of the apical resection was 2.88 mm along the direction of the long axis of the tooth, which was 0.12 mm lower than the preset 3 mm. The included angle between the apical resection plane and the long axis of the tooth was 77.9°, 12.1° lower than the preset 90°.
This study successfully established a digital design and production method of apicoectomy guide template by combing the multi-source data fusion, CAD and FDM technology. The design route and the production method are feasible. The study will provide a technology and methodology reference for the development of domestic special software for the digital design of apicoectomy guide template.
基于多源数据融合、计算机辅助设计（CAD）和熔融沉积建模（FDM），建立根尖切除术导板模板的设计与制造方法。通过体外模型实验初步评估导板模板的可行性。
选取一颗根管治疗后的上颌前牙进行光学扫描，然后将该上颌前牙灌注到根尖切除术石膏模型中。对根尖切除术石膏模型进行锥形束计算机断层扫描（CBCT），之后对根尖切除手术的石膏模型进行光学扫描。将上颌前牙及根尖切除术石膏模型的所有相关CBCT和光学扫描数据导入Geomagic Studio 2012软件。利用多源数据融合技术虚拟模拟患牙、牙列、牙槽骨及牙龈的三维位置关系，在此基础上，于Geomagic Studio 2012软件中完成根尖切除术导板模板的三维设计。采用熔融沉积建模技术，以聚乳酸（PLA）材料对根尖切除手术导板模板进行三维打印。在手术导板模板的引导下，在石膏模型上进行根尖切除术。根尖切除术后，将上颌前牙从根尖切除术石膏模型上取下，然后进行光学扫描。通过距离测量和角度测量功能计算根尖切除长度和角度，并将结果与预设值进行比较。
沿牙齿长轴方向的根尖切除长度为2.88 mm，比预设的3 mm低0.12 mm。根尖切除平面与牙齿长轴的夹角为77.9°，比预设的90°低12.1°。
本研究通过多源数据融合、CAD和FDM技术成功建立了根尖切除术导板模板的数字化设计与制作方法。该设计路线和制作方法可行。本研究将为国内根尖切除术导板模板数字化设计专用软件的开发提供技术和方法参考。
