Wong Sonny, Deng Han, Gateno Jaime, Yuan Peng, Garrett Fred A, Ellis Randy K, English Jeryl D, Jacob Helder B, Kim Daeseung, Xia James J
Resident, Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX.
Postdoctoral Fellow, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX.
J Oral Maxillofac Surg. 2020 May;78(5):799-805. doi: 10.1016/j.joms.2019.12.021. Epub 2020 Jan 7.
Methods for digital dental alignment are not readily available to automatically articulate the upper and lower jaw models. The purpose of the present study was to assess the accuracy of our newly developed 3-stage automatic digital articulation approach by comparing it with the reference standard of orthodontist-articulated occlusion.
Thirty pairs of stone dental models from double-jaw orthognathic surgery patients who had undergone 1-piece Le Fort I osteotomy were used. Two experienced orthodontists manually articulated the models to their perceived final occlusion for surgery. Each pair of models was then scanned twice-while in the orthodontist-determined occlusion and again with the upper and lower models separated and positioned randomly. The separately scanned models were automatically articulated to the final occlusion using our 3-stage algorithm, resulting in an algorithm-articulated occlusion (experimental group). The models scanned together represented the manually articulated occlusion (control group). A qualitative evaluation was completed using a 3-point categorical scale by the same orthodontists, who were unaware of the methods used to articulate the models. A quantitative evaluation was also completed to determine whether any differences were present in the midline, canine, and molar relationships between the algorithm-determined and manually articulated occlusions using repeated measures analysis of variance (ANOVA). Finally, the mean ± standard deviation values were computed to determine the differences between the 2 methods.
The results of the qualitative evaluation revealed that all the algorithm-articulated occlusions were as good as the manually articulated ones. The results of the repeated measures ANOVA found no statistically significant differences between the 2 methods [F(1,28) = 0.03; P = .87]. The mean differences between the 2 methods were all within 0.2 mm.
The results of our study have demonstrated that dental models can be accurately, reliably, and automatically articulated using our 3-stage algorithm approach, meeting the reference standard of orthodontist-articulated occlusion.
目前尚缺乏能够自动对上下颌模型进行咬合的数字化牙齿对齐方法。本研究的目的是通过将我们新开发的三阶段自动数字化咬合方法与正畸医生手动咬合的参考标准进行比较，来评估该方法的准确性。
使用30对接受单节段Le Fort I截骨术的双颌正颌手术患者的石膏牙模型。两名经验丰富的正畸医生将模型手动调整到他们认为的手术最终咬合状态。然后，每对模型进行两次扫描，一次是在正畸医生确定的咬合状态下，另一次是将上下模型分开并随机定位后进行扫描。使用我们的三阶段算法将单独扫描的模型自动调整到最终咬合状态，从而得到算法咬合状态（实验组）。一起扫描的模型代表手动咬合状态（对照组）。由同样不知道模型咬合方法的正畸医生使用三点分类量表完成定性评估。还完成了定量评估，以使用重复测量方差分析（ANOVA）确定算法确定的咬合和手动咬合在中线、尖牙和磨牙关系上是否存在差异。最后，计算平均值±标准差来确定两种方法之间的差异。
定性评估结果显示，所有算法咬合状态与手动咬合状态一样好。重复测量方差分析结果表明，两种方法之间没有统计学上的显著差异[F(1,28)=0.03；P=0.87]。两种方法之间的平均差异均在0.2毫米以内。
我们的研究结果表明，使用我们的三阶段算法方法可以准确、可靠且自动地对牙模型进行咬合，符合正畸医生手动咬合的参考标准。
