口内扫描与数字化最终咬合关系建立在正颌外科三维计划中的应用：与牙模方法的比较。
Intraoral Scanning and Setting Up the Digital Final Occlusion in Three-Dimensional Planning of Orthognathic Surgery: Its Comparison with the Dental Model Approach.
机构信息
From the Division of Orthodontics, Department of Dentistry, the Craniofacial Research Center, and the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital.
出版信息
Plast Reconstr Surg. 2019 May;143(5):1027e-1036e. doi: 10.1097/PRS.0000000000005556.
BACKGROUND
Three-dimensional surgical planning for orthognathic surgery is becoming prevalent, with improving outcomes. However, conventional dental casts are still used for evaluations, digital image conversion, surgical planning, and occlusal splint production. This study used intraoral scanning for the three-dimensional planning of the final digital occlusion and compared this method with the conventional dental cast approach.
METHODS
Thirty consecutive patients who underwent two-jaw orthognathic surgery to treat mandibular prognathism and asymmetry were included. Dental casts (control group) and intraoral scans (study group) were collected simultaneously for designing the final dental occlusion. A step-by-step setup of the final digital occlusion was established for the study group. To validate results, the intraoral scanning-based virtual occlusion was superimposed over the dental model-based final digital occlusion for comparison. Intraobserver and interobserver variability were assessed for setting up the final digital occlusion. The fitness of splints fabricated using the conventional and virtual occlusion methods were compared.
RESULTS
The steps for setting up the final digital occlusion were applicable in all cases. The average root-mean-square difference of final occlusion images between the two groups was 0.45 mm, indicating a comparable occlusal relationship. The intraobserver reproducibility and interobserver reliability for setting up the virtual occlusion were satisfactory. Moreover, no significant difference existed in the splint fitness test between the groups.
CONCLUSIONS
The proposed intraoral scan and setup process of the final digital occlusion was reliable and accurate. Thus, the method can replace the dental model approach for the three-dimensional planning of orthognathic surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
背景
正颌手术的三维手术规划越来越流行，手术效果也有所改善。然而，传统的牙模仍用于评估、数字图像转换、手术规划和咬合夹板制作。本研究使用口内扫描进行最终数字咬合的三维规划，并将该方法与传统牙模方法进行比较。
方法
连续纳入 30 例因下颌前突和不对称接受双颌正颌手术的患者。同时采集牙模（对照组）和口内扫描（研究组），用于设计最终的牙咬合。为研究组建立了最终数字咬合的分步设置。为了验证结果，将基于口内扫描的虚拟咬合与基于牙模的最终数字咬合进行叠加比较。评估设置最终数字咬合的观察者内和观察者间变异性。比较使用传统和虚拟咬合方法制作的夹板的贴合度。
结果
设置最终数字咬合的步骤适用于所有病例。两组最终咬合图像的平均均方根差为 0.45 毫米，表明咬合关系相当。设置虚拟咬合的观察者内可重复性和观察者间可靠性良好。此外，两组之间的夹板贴合度测试无显著差异。
结论
所提出的口内扫描和最终数字咬合设置过程可靠且准确。因此，该方法可以替代牙模方法用于正颌手术的三维规划。
临床问题/证据水平：治疗，II 级。
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