Guo Shan-Lin, He Xiao, Tang Zhi, Xie Bing-Ying, Mao Min-Jie, Shen Xiao-Qing, Geng Yuan-Ming, Li Wei
Department of Stomatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Medical Biomechanics, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
Int Dent J. 2025 Jul 15;75(5):100901. doi: 10.1016/j.identj.2025.100901.
To investigate how different virtual articulator parameter settings influence clinical outcomes of posterior CAD/CAM restorations designed with the CEREC system's biogeneric model, specifically regarding occlusal rehabilitation.
Twenty participants (11 females, 9 males; mean age 35.50 ± 5.23 years) each received four crowns designed under one of four protocols: (1) No Virtual Articulator Parameters (NVAP), (2) Mean Virtual Articulator Parameters (MVAP), (3) Partially Personalised Virtual Articulator Parameters (PPVAP), and (4) Fully Personalised Virtual Articulator Parameters (FPVAP). Subjective comfort was assessed via the Visual Analogue Scale and Likert scale. Intraoral scans were analysed using Geomagic Control X 2020 software to assess occlusal contact areas and points at single-tooth and full-arch levels. One-year restoration survival was not recorded.
MVAP and FPVAP showed significantly lower Visual Analogue Scale scores than NVAP (P = .0084, P = .0002, respectively). Likert scale ratings did not differ among groups (P = .9921). All crown designs reduced occlusal contact areas compared to the pre-preparation state (P < .05), with FPVAP exhibiting the most favorable outcomes, though not significantly different from other designs. Full-arch analysis revealed no significant changes in contact areas (P = .2645) or contact points (P = .5015). Two NVAP restorations fractured within one year (P = .0348), indicating a trend favoring increased parameter personalization.
Mean-value or fully personalised virtual articulator parameters in CAD/CAM crown design yield superior patient comfort and maintain more accurate occlusal relationships compared to non-personalised approaches. Mean-value settings present a practical option for general clinical use, although larger-scale studies with extended follow-up are recommended.
By integrating mean-value or fully personalised virtual articulator parameters into CAD/CAM restoration workflows, clinicians can significantly enhance patient comfort and occlusal accuracy. These findings highlight the importance of tailoring design parameters in routine practice to improve restoration outcomes and potentially lower the likelihood of failure.
研究不同的虚拟牙合架参数设置如何影响使用CEREC系统的生物通用模型设计的后牙CAD/CAM修复体的临床效果,特别是在咬合重建方面。
20名参与者(11名女性,9名男性;平均年龄35.50±5.23岁)每人接受了按照四种方案之一设计的四个牙冠:(1)无虚拟牙合架参数(NVAP),(2)平均虚拟牙合架参数(MVAP),(3)部分个性化虚拟牙合架参数(PPVAP),以及(4)完全个性化虚拟牙合架参数(FPVAP)。通过视觉模拟量表和李克特量表评估主观舒适度。使用Geomagic Control X 2020软件对口腔内扫描进行分析,以评估单颗牙和全牙弓水平的咬合接触面积和接触点。未记录一年的修复体存留情况。
MVAP和FPVAP的视觉模拟量表得分显著低于NVAP(分别为P = 0.0084,P = 0.0002)。各组的李克特量表评分无差异(P = 0.9921)。与预备前状态相比,所有牙冠设计均减小了咬合接触面积(P < 0.05),FPVAP表现出最有利的结果,尽管与其他设计无显著差异。全牙弓分析显示接触面积(P = 0.2645)或接触点(P = 0.5015)无显著变化。两个NVAP修复体在一年内发生折断(P = 0.0348),表明有参数个性化增加更有利的趋势。
与非个性化方法相比,CAD/CAM牙冠设计中的平均值或完全个性化虚拟牙合架参数可带来更高的患者舒适度,并维持更精确的咬合关系。平均值设置为一般临床应用提供了一个实用选择,不过建议进行更大规模的长期随访研究。
通过将平均值或完全个性化虚拟牙合架参数整合到CAD/CAM修复工作流程中,临床医生可显著提高患者舒适度和咬合准确性。这些发现凸显了在常规实践中调整设计参数以改善修复效果并可能降低失败可能性的重要性。