Oral & Maxillofacial Trainee, Westmead Hospital, Sydney, Australia.
Consultant Oral & Maxillofacial Surgeon, Private Practice, Sydney, Australia.
Br J Oral Maxillofac Surg. 2022 May;60(4):443-447. doi: 10.1016/j.bjoms.2021.07.013. Epub 2021 Jul 24.
The aim of the present study was to develop measurement methods to evaluate occlusal differences in digitally-articulated and hand-articulated models in final occlusal planning for orthognathic surgery. A total of 10 (five class II and five class III) previously treated orthognathic cases were analysed by three oral and maxillofacial surgeon investigators, creating a total of thirty cases. Investigators used physical models to create a preferred hand-held final occlusion, which were then scanned and saved utilising a Trios 3® scanner (3Shape). Models were digitally disarticulated and sent back to investigators after a period of at least a month for digital articulation. Novel measurements of dental roll, pitch, and translational differences were performed by an independent engineer using Materialise 3-Matic® software. Statistical analysis was used to evaluate translational differences, the effect of deformity, and inter-investigator variation. A mean (SD) translational difference of 1.58 mm (1.14) mm was seen between the thirty digital and hard-articulated cases analysed. Minimal difference was seen in roll and pitch between hand articulation and digital articulation. A significant translational difference was seen in class III cases compared with class II (p = 0.0006) but not in roll or pitch. There was no significant difference seen between investigators related to translation (p = 0.18), roll (p = 0.09), or pitch (p = 0.17). Digital articulation yielded similar results to hand held in this pilot study. Using measurement techniques described in larger cohorts, its accuracy can be validated using currently available technology.
本研究旨在开发测量方法，以评估数字化和手工制作模型在正颌手术最终咬合规划中的咬合差异。总共分析了 10 个（5 个 II 类和 5 个 III 类）以前治疗过的正颌病例，由 3 名口腔颌面外科医生进行分析，共产生了 30 个病例。调查员使用物理模型来创建首选的手持最终咬合，然后使用 Trio3®扫描仪（3Shape）进行扫描和保存。模型在数字化分离后，至少在一个月后送回调查员进行数字化关节。一位独立工程师使用 Materialise 3-Matic®软件对牙列滚动、俯仰和平移差异进行了新的测量。使用统计分析来评估平移差异、畸形的影响和调查员之间的差异。分析了 30 个数字和硬关节病例，发现平均（SD）平移差异为 1.58mm（1.14）mm。手关节和数字关节之间的滚动和俯仰差异最小。与 II 类病例相比，III 类病例的平移差异有显著差异（p = 0.0006），但在滚动或俯仰方面没有差异。在平移方面，调查员之间没有显著差异（p = 0.18）、滚动（p = 0.09）或俯仰（p = 0.17）。在这个试点研究中，数字化关节与手持关节产生了相似的结果。使用更大样本量中描述的测量技术，可以使用当前可用的技术验证其准确性。
