State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China.
BMC Oral Health. 2022 Aug 26;22(1):365. doi: 10.1186/s12903-022-02394-w.
Accurate integration of the dentitions with the face is essential in dental clinical practice. Here we introduce a noninvasive and efficient protocol to integrate the digitized maxillary dentition with the three-dimensional (3D) facial photo using a prefabricated modified computer-aided design/computer-aided manufacture (CAD/CAM) facebow.
To integrate the maxillary dentition with the 3D facial photo, the CAD/CAM facebow protocol was applied to 20 patients by taking a series of 3D facial photos in the clinic and integrating them in the laboratory. The integration accuracy of this protocol was compared with that of a valid 3D computed tomography (CT)-aided protocol concerning translational deviations of the landmarks representing maxillary incisors and maxillary first molars as well as the rotational deviation of the maxillary dentition. The intra- and inter-observer reproducibility was assessed, and the time of clinical operation and laboratory integration was recorded.
This facebow-aided protocol generated 3D fused images with colored faces and high-resolution dentitions, and showed high reproducibility. Compared with the well-established CT-aided protocol, the translational deviations ranged from 0 to 1.196 mm, with mean values ranging from 0.134 to 0.444 mm, and a relatively high integration error was found in the vertical dimension (Z) with a mean ± standard deviation (SD) of 0.379 ± 0.282 mm. Meanwhile, the rotational deviations ranged from 0.020 to 0.930°, with mean values less than 1°, and the most evident deviation was seen in pitch rotation with a mean ± SD of 0.445 ± 0.262°. The workflow took 4.34 ± 0.19 min (mins) for clinical operation and 11.23 ± 0.29 min for laboratory integration.
The present radiation-free protocol with the modified CAD/CAM facebow provided accurate and reproducible transfer of the digitized maxillary dentition to the 3D facial photo with high efficiency.
准确整合牙列与面部在牙科临床实践中至关重要。在这里，我们介绍了一种非侵入性且高效的方案，使用预制的改良计算机辅助设计/计算机辅助制造 (CAD/CAM) 面弓将数字化的上颌牙列与三维 (3D) 面部照片进行整合。
为了将上颌牙列与 3D 面部照片进行整合，我们通过在诊所拍摄一系列 3D 面部照片并在实验室中进行整合，将 CAD/CAM 面弓方案应用于 20 名患者。该方案的整合准确性与有效的 3D 计算机断层扫描 (CT) 辅助方案进行了比较，比较了代表上颌切牙和上颌第一磨牙的标志点的平移偏差以及上颌牙列的旋转偏差。评估了观察者内和观察者间的可重复性，并记录了临床操作和实验室整合的时间。
该面弓辅助方案生成了具有彩色面部和高分辨率牙列的 3D 融合图像，具有很高的可重复性。与成熟的 CT 辅助方案相比，平移偏差范围为 0 至 1.196 毫米，平均值范围为 0.134 至 0.444 毫米，在垂直方向（Z）上存在较高的整合误差，平均值为 0.379 ± 0.282 毫米。同时，旋转偏差范围为 0.020 至 0.930°，平均值小于 1°，最明显的偏差是在俯仰旋转，平均值为 0.445 ± 0.262°。工作流程在临床操作中需要 4.34 ± 0.19 分钟（mins），在实验室整合中需要 11.23 ± 0.29 分钟。
本研究中使用改良 CAD/CAM 面弓的无辐射方案能够高效、准确且可重复地将数字化的上颌牙列转移到 3D 面部照片上。
