Zhang X Y, Wang Y, Pan Z Q, Liu Y Y, Zhao Y J
Center of Digital Dentistry, Faculty of Prosthodontics, 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 & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & Beijing Key Laboratory of Digital Stomatology, Beijing100081, China.
Department of Cariology and Endodontology, 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 Key Laboratory of Digital Stomatology, Beijing100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2024 Nov 9;59(11):1114-1119. doi: 10.3760/cma.j.cn112144-20240709-00263.
To explore the digital design and fabrication technology of personalized restorative matrix for dental filling, and to explore the feasibility of direct resin restoration for deep caries lesions in distal neck of mandibular second molar. For patients with deep caries lesions in the distal neck of the mandibular second molar who visited the Department of Cariology and Endodontology of Peking University School and Hospital of Stomatology from September 2023 to April 2024, after preparing the cavity and gingival retractor, a three-dimensional intraoral scanner was used to obtain three-dimensional data of the patient's dentition. In the dental restoration computer-aided design software, the inlay function was used to generate the restored tooth morphology. The edge range of the personalized restorative matrix was drawn on the restored model by three-dimensional reverse engineering software to achieve edge sealing effect. The selected edge range data was processed with distal shelling to generate a digital model of a personalized restorative matrix with a thickness of 0.5 mm. A metal three-dimensional printer was used to fabricate the titanium alloy restorative matrix, and its application was completed in 10 clinical cases. The marginal adaptation and retention stability of the personalized restorative matrix were evaluated under a dental microscope, and forming effect evaluation was performed through immediate postoperative periapical radiographs. The preliminary clinical application of the personalized restorative matrix fabricated using digital technology revealed that, in the treatment of 10 affected teeth, rubber dam isolation was successfully ensured, resulting in clinically effective direct resin composite restorations with optimal marginal adaptation and reasonable contours. Immediate postoperative periapical radiographs showed good convexity of the filling body, with no overhangs found. Both marginal adaptation and retention stability met the requirements of clinical treatment. The personalized restorative matrix designed in this study can solve the clinical problems of moisture separation and resin forming in the treatment of deep caries lesions in distal neck of the mandibular second molar, and can achieve stable and reliable adhesive restoration effects.
探索用于牙体充填的个性化修复基质的数字化设计与制作技术,探讨下颌第二磨牙远中颈部深龋病变直接树脂修复的可行性。对于2023年9月至2024年4月就诊于北京大学口腔医院牙体牙髓科的下颌第二磨牙远中颈部深龋病变患者,在制备窝洞及牙龈收缩后,使用三维口内扫描仪获取患者牙列的三维数据。在牙科修复计算机辅助设计软件中,利用嵌体功能生成修复后牙齿形态。通过三维逆向工程软件在修复模型上绘制个性化修复基质的边缘范围,以实现边缘封闭效果。对所选边缘范围数据进行远端去壳处理,生成厚度为0.5mm的个性化修复基质数字模型。使用金属三维打印机制作钛合金修复基质,并在10例临床病例中完成应用。在牙科显微镜下评估个性化修复基质的边缘适合性和固位稳定性,并通过术后即刻根尖片进行成型效果评估。采用数字技术制作的个性化修复基质的初步临床应用显示,在治疗的10颗患牙中,成功确保了橡皮障隔离,实现了临床有效的直接树脂复合修复,边缘适合性最佳,外形轮廓合理。术后即刻根尖片显示充填体凸度良好,未发现悬突。边缘适合性和固位稳定性均符合临床治疗要求。本研究设计的个性化修复基质能够解决下颌第二磨牙远中颈部深龋病变治疗中隔湿和树脂成型的临床问题,并能实现稳定可靠的粘结修复效果。