Storelli Stefano, Palandrani Giulia, Amorfini Leonardo, Scanferla Massimo, Ausenda Federico, Romeo Eugenio
Int J Comput Dent. 2020;23(3):269-279.
The utilization of digital 3D surface images (STL format) for planning cases of computer-guided implant surgery is very useful in partially edentulous cases. In fully edentulous cases, however, the absence of teeth makes it necessary to add reference markers. The proposed protocol demonstrates a simple procedure that allows for the superimposition of STL and radiologic data (DICOM format). In the presented patient case, the tissue-bearing area of the prosthesis was relined with a polysulfide impression material and sent to the laboratory. A master cast was produced. The prosthesis was relined to improve intraoral stability and was provided with at least three radiopaque 3D markers. An STL copy of the prosthesis and the model was generated through a laboratory scanner. The patient wore the prosthesis with the attached markers during the 3D radiologic examination. In the planning software (CoDiagnostiX; Dental Wings), the prosthesis markers on the STL were matched to the corresponding markers visible on the DICOM data. Then, the STL of the model was matched to that of the prosthesis. Once the STL of the mucosa and the prosthesis were imported into the software, new possibilities arose, ie, the option to add other digital or traditional tooth setups to the same radiologic data or to design a surgical guide based on the actual mucosa of the patient.
利用数字3D表面图像（STL格式）来规划计算机引导种植手术病例，在部分牙列缺损病例中非常有用。然而，在全口牙列缺失病例中，由于没有牙齿，有必要添加参考标记。所提出的方案展示了一种简单的程序，可实现STL数据与放射学数据（DICOM格式）的叠加。在本病例中，用聚硫橡胶印模材料对义齿的组织承托区进行重衬，然后送至实验室。制作了一个主模型。对义齿进行重衬以提高口腔内稳定性，并至少设置三个不透射线的3D标记。通过实验室扫描仪生成义齿和模型的STL副本。患者在进行3D放射学检查时佩戴带有附着标记的义齿。在规划软件（CoDiagnostiX；Dental Wings）中，将STL上的义齿标记与DICOM数据上可见的相应标记进行匹配。然后，将模型的STL与义齿的STL进行匹配。一旦将黏膜和义齿的STL导入软件，就会出现新的可能性，即可以在相同的放射学数据上添加其他数字或传统的牙齿排列方式，或者根据患者的实际黏膜设计手术导板。
