Wang S M, Li Z, Wang G B, Ye H Q, Liu Y S, Tong D, Gao W H, Zhou Y S
Department of Prosthodontics, 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.
Dental Laboratory, 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.
Beijing Da Xue Xue Bao Yi Xue Ban. 2019 Feb 18;51(1):105-110. doi: 10.19723/j.issn.1671-167X.2019.01.019.
To establish a complete workflow of digital design and manufacturing occlusal splint for sleep bruxism, which can be preliminarily applied in clinical use, thus observe the clinical efficacy.
Twenty-four patients with sleep bruxism were recruited in the study and randomly divided into two groups by using random number tables. Digital-occlusal-splint (experimental group) treatment plan and traditional-occlusal-splint (control-group) treatment plan were carried out for each group, respectively. For experimental group, digital models of patients' both dental arches and the occlusion relationship after elevation were captured using an intraoral scanner. The occlusal splint was carried out by computer aided design/computer aided manufacturing (CAD/CAM), including splint designing and milling. For control group, the traditional soft occlusal splint was fabricated by vacuum laminator. The two kinds of occlusal splints were tried in the patients from each group, and the occlusal contacts were tested respectively by T-scan analysis system, which recorded the changes of occlusal indicators in the two groups. The retention, appearance and occlusal comfort degree were evaluated by the two groups of patients. Mann-Whitney test was performed with IBM SPSS 20.0 software, and bilateral test was performed. P<0.05 was considered to be statistically significant.
The complete workflow of digital design and manufacturing occlusal splint was successfully established. During the clinical use, there was no statistical difference in the retention evaluation of two kinds of occlusal splints between the two groups of patients (Z=-0.538, P=0.590). The appearance score (Z=2.038, P=0.042) and the occlusal comfort score (Z=-2.579, P=0.010) of the experimental group were higher than those of the control group, with statistically significant differences. The T-scan analysis results showed that only the second molar on both sides of the traditional occlusal splint had occlusal contact in intercupsal position, while the digital occlusal splint had stable and bilaterally balanced contact between the maxillary and mandibular teeth. Furthermore, the occlusal force was uniformly distributed in the experimental group.
The complete workflow of digital occlusal splint improves the occlusal design, greatly simplifies and optimizes the traditional process of making occlusal splint. This new method is resource-saving and environmental-friendly, and it is able to serve patients more conveniently and efficiently.
建立一套完整的用于治疗磨牙症的数字设计与制造咬合板的工作流程，使其能初步应用于临床，进而观察其临床疗效。
本研究招募了24名磨牙症患者，使用随机数字表将其随机分为两组。分别对每组实施数字咬合板（实验组）治疗方案和传统咬合板（对照组）治疗方案。对于实验组，使用口腔内扫描仪获取患者双侧牙弓及抬高后的咬合关系的数字模型。通过计算机辅助设计/计算机辅助制造（CAD/CAM）制作咬合板，包括夹板设计和铣削。对于对照组，使用真空层压机制作传统软质咬合板。将两种咬合板分别在每组患者口中试戴，并用T-scan分析系统分别测试咬合接触情况，记录两组咬合指标的变化。由两组患者对保持性、外观和咬合舒适度进行评价。使用IBM SPSS 20.0软件进行Mann-Whitney检验，并进行双侧检验。P<0.05被认为具有统计学意义。
成功建立了数字设计与制造咬合板的完整工作流程。在临床使用过程中，两组患者对两种咬合板的保持性评价无统计学差异（Z=-0.538，P=0.590）。实验组的外观评分（Z=2.038，P=0.042）和咬合舒适度评分（Z=-2.579，P=0.010）均高于对照组，差异具有统计学意义。T-scan分析结果显示，传统咬合板双侧仅第二磨牙在牙尖交错位有咬合接触，而数字咬合板上颌和下颌牙齿之间有稳定且双侧平衡的接触。此外，实验组的咬合力分布均匀。
数字咬合板的完整工作流程改善了咬合设计，极大地简化并优化了传统咬合板制作工艺。这种新方法节约资源且环保，能够更方便、高效地为患者服务。
