摘要： 目的 评估计算机数控 (CNC) 铣削技术中计算机辅助设计 (CAD) 和铣削步骤对不同牙预备体的钛金属冠三维适合性的影响。方法 应用Imageware软件构建5种形态的牙预备体数据,应用牙科软件分别设计得到牙冠数据,然后将各牙冠数据铣削得到钛金属冠。喷砂后,采用E4模型扫描获取牙冠凹面数据,采用Studio 软件最佳拟合配准获得颜色偏差图和均方根误差 (RMSE),最后对CAD和铣削步骤后的RMSE进行统计分析。结果 经CAD步骤后,5个设计组颜色偏差图不完全相同,RMSE均值范围为27.99~31.01 μm; 经CAD和铣削步骤后,各设计组颜色偏差图发生明显变化,RMSE均值范围为22.62~55.20 μm; 铣削步骤本身的RMSE均值范围为-6.26~24.19 μm,且90°翘边组RMSE均值为 (24.19±7.48) μm,较其他设计组更大 (P < 0.05)。与CAD步骤相比,铣削步骤牙冠的RMSE均值更小 (P < 0.05)。结论 CAD或铣削步骤均易对钛金属冠三维适合性产生影响,且影响程度因预备体形态而存在差异,但这种差异与临床可接受的适合性偏差相比较小。

计算机数控铣削技术对不同牙预备体的钛金属冠三维适合性的影响

喻娜^1,2,3, 陈剑⁴, 谭发兵^1,2,3, 周后祺⁵, 王鹏⁵

1. 重庆医科大学附属口腔医院修复工艺科, 重庆 400015;
2. 口腔疾病与生物医学重庆市重点实验室, 重庆 400015;
3. 重庆市高校市级口腔生物医学工程重点实验室, 重庆 400015;
4. 重庆市药品技术审评认证中心医疗器械生产审查科, 重庆 401120;
5. 重庆晶美义齿制作有限公司, 重庆 400015

收稿日期:2021-05-21出版日期:2022-10-30发布日期:2022-10-14
通讯作者:谭发兵E-mail:xiaosongtan1983@hospital.cqmu.edu.cn
作者简介:喻娜(1986-),女,主管技师,硕士.
基金资助:重庆市科技局技术创新与应用发展专项(cstc2020jscx-sbqwX0006);重庆市教育委员会科学技术研究计划(KJQN202100439)


关键词: 计算机辅助设计, 铣削, 牙预备体设计, 钛金属冠, 三维适合性
Abstract: Objective To evaluate the effects of computer aided design (CAD) and milling procedures in computer numerical control (CNC) milling technology on the three-dimensional fit of titanium crowns with different tooth preparation designs.Methods Five preparation data were constructed using Imageware software,after which design crowns were obtained,and then the crown data were milled to obtain titanium actual crowns.After sandblasting,E4 model scanning was used to obtain the intaglio surfaces data of the actual crowns,and after obtaining the best-fit algorithm using the Studio software,the three-dimensional fit was displayed with colors,while the root mean square error (RMSE) was calculated and analyzed.Results After the CAD procedure,the color-coded images of the five design groups were not identical,and the mean RMSE ranged from 27.99 to 31.01 μm.After the CAD and milling procedures,the color-coded images of each design group changed obviously,and the mean RMSE ranged from 22.62 to 55.20 μm.The mean RMSE of the milling procedure itself ranged from-6.26 to 24.19 μm,and the mean RMSE of the 90° with lipped margins group was higher than that of the other design groups (P < 0.05).In addition,compared with the CAD procedure,the mean RMSE of crowns in the milling procedure was smaller (P < 0.05).Conclusion CAD or milling procedures are prone to affect the three-dimensional fit of titanium crown,and the degree of influence varies with the design of the tooth preparation.However,comparing to clinically acceptable fit discrepancies,the differences are relatively small.
Key words: computer aided design, milling, tooth preparation design, titanium crown, three-dimensional fit
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