Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, PR China.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, PR China.
J Dent. 2024 Dec;151:105404. doi: 10.1016/j.jdent.2024.105404. Epub 2024 Oct 13.
To evaluate the effectiveness of computer-aided design (CAD)/computer-aided manufacturing (CAM) in designing and manufacturing 3D-printed dental models used to make thermoplastic removable splints for children with traumatized anterior permanent teeth.
A total of 28 patients with dental trauma (subluxation, extrusive luxation, and lateral luxation) were divided into experimental (14 patients) and control groups (14 patients). The experimental group was treated with the removable splint made using a new 3D printed dental model designed with CAD/CAM technology, while the control group received a wire-composite splint. Follow-up was performed at week 2 and 1, 2, 3, 6, 12, 18, and 24 months post-treatment, and every year after that. The traumatized teeth were evaluated according to clinical symptoms, tooth color, mobility, position, percussion pain, abnormal percussion sounds indicating ankylosis or other pathosis, swelling, fistula of gums, vitality test, and radiographic examination.
No significant difference was found in gender and age between the two groups. The experimental group had 23 traumatic teeth, and the control group had 24 traumatic teeth. Traumatic teeth in the two groups most commonly involved open apex teeth (>90 %). The average follow-up time for the experimental and control group was 35.47±14.23 and 32.92±14.79 months (P > 0.05), respectively. The pulp survival rate and periodontal healing rate in the experimental group (86.96 %, 91.30 %) were higher compared to the control group (62.50 %, 75.00 %) (all P > 0.05).
A removable splint made by a 3D printed dental model designed with CAD/CAM technology achieved an equivalent treatment effect to a wire-composite splint.
A 3D-printed dental model designed with CAD/CAM technology can be used to fabricate removable splints, which in turn can decrease iatrogenic injuries frequently encountered during the traditional model production process. For example, taking the impression directly from the patient's mouth can cause displacement of a traumatized tooth or even exfoliation. The removable splints produced using a new 3D-printed dental model can meet clinical treatment requirements of traumatized teeth, especially for children and adolescents with occlusal trauma in mixed dentition.
评估计算机辅助设计（CAD）/计算机辅助制造（CAM）在设计和制造用于制作儿童创伤前恒牙热塑性可摘夹板的 3D 打印牙模中的效果。
共纳入 28 例牙外伤患者（半脱位、外脱位和侧方脱位），分为实验组（14 例）和对照组（14 例）。实验组采用 CAD/CAM 技术设计的新型 3D 打印牙模制作可摘夹板，对照组采用金属丝-复合树脂夹板。治疗后 2 周和 1、2、3、6、12、18、24 个月及此后每年进行随访，观察记录患牙的临床症状、牙体色、动度、位置、叩诊痛、异常叩诊音提示粘连或其他病变、肿胀、牙龈瘘管、活力测试和影像学检查。
两组患者性别和年龄差异无统计学意义。实验组有 23 颗创伤牙，对照组有 24 颗创伤牙。两组中最常见的创伤牙为根尖开放牙（>90%）。实验组和对照组的平均随访时间分别为 35.47±14.23 个月和 32.92±14.79 个月（P>0.05）。实验组牙髓存活率（86.96%）和牙周愈合率（91.30%）高于对照组（62.50%、75.00%）（均 P>0.05）。
CAD/CAM 技术设计的 3D 打印牙模制作的可摘夹板与金属丝-复合树脂夹板的治疗效果相当。
CAD/CAM 技术设计的 3D 打印牙模可用于制作可摘夹板，从而减少传统模型制作过程中经常出现的医源性损伤。例如，直接从患者口腔取印模可能导致创伤牙移位甚至脱落。使用新型 3D 打印牙模制作的可摘夹板可满足创伤牙的临床治疗要求，尤其是儿童和青少年混合牙列中咬合创伤的治疗。
