增材与减材数字化工作流程对可摘咬合稳定夹板精度的比较——一项体外研究
Comparison of additive and subtractive digital workflow for the accuracy of removable occlusal stabilization-splints - an in-vitro study.
文献信息
| PMID | 42853434 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Anna-Lena Willmann |
| 作者单位 | Department of Operative Dentistry and Periodontology, University Hospital Bonn, Welschnonnenstrasse 17, 53111, Bonn, Germany. |
| 期刊 | Clinical oral investigations |
| SCI 分区 | Q1 |
| IF | 3.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： IV期牙周炎患者常因牙齿缺失的解剖和功能后果而需要对受损牙列进行额外修复。可摘咬合夹板在这些晚期病例中可能有帮助。本体外研究比较了由标准化STL文件通过3D打印和铣削制作的可摘咬合夹板的精度和内部适合性。
材料与方法： 从上颌扫描主模型创建标准曲面细分语言（STL）文件，并用于生产四十个相同的夹板。二十个夹板为3D打印，二十个为铣削。随后对所有夹板重新扫描，得到新的STL文件，并与原始STL文件进行比较。在42个预定义点评估两种方法的精度。比较磨牙间从前庭到前庭（v-v）以及从腭侧到腭侧（p-p）的距离。使用Mann-Whitney检验进行比较（p < 0.05）。
结果： 平均值为43.9 ± 31.29 μm（3D）和22.0 ± 18.46 μm（铣削），组间差异显著（p < 0.001，Mann-Whitney）。3D技术通常导致收缩（平均值（SD）v-v：平均 - 13.0 μm（± 92.16）；p-p：-9.3 μm（± 123.03））。铣削技术从前庭到前庭收缩（-4.0 μm（± 53.63）），但从腭侧到腭侧测量到扩张（38.5 μm（± 33.86））。前庭侧，组间差异不显著（p = 0.862，Mann-Whitney），但第二磨牙腭侧显著（p < 0.001，Mann-Whitney）。
结论： 两种技术显示的偏差与先前数字化制造咬合夹板的体外研究相当。铣削制造在牙弓后部区域发现较少偏差。
临床相关性： 使用CAD/CAM制造可摘咬合夹板似乎是一种精确且舒适的选择。
英文摘要
OBJECTIVES: Patients with stage IV periodontitis often require additional rehabilitation of the compromised dentition due to anatomical and functional consequences of tooth loss. Removable occlusal splints can be helpful in these advanced cases. This in-vitro study compared the accuracy and internal fit of removable occlusal splints fabricated by 3D-printing and milling from a standardized STL-file.
MATERIALS AND METHODS: A standard-tessellation-language (STL)-file was created from a scanned master-model of the upper jaw and used for production of forty identical splints. Twenty splints were 3D-printed and twenty were milled. Subsequently all splints were rescanned, new STL-files resulted, which were compared with the original STL-file. Accuracy of both methods were assessed at 42 predefined points. Distances from vestibular to vestibular (v-v) respectively palatinal to palatinal (p-p) between molars were compared. Mann-Whitney-test was used for comparison (p < 0.05).
RESULTS: Mean values were 43.9 ± 31.29 μm (3D) and 22.0 ± 18.46 μm (milled), with a significant difference between groups (p < 0.001, Mann-Whitney). The 3D technique resulted generally in a contraction (mean (SD) v-v: mean - 13.0 μm (± 92.16); p-p: -9.3 μm (± 123.03)). With the milled technique, a contraction vestibular-to-vestibular (-4.0 μm (± 53.63)), but palatinal-to-palatinal an expansion was measured (38.5 μm (± 33.86)). Vestibular, differences between groups were not significant (p = 0.862, Mann-Whitney), but palatinal at the second molar (p < 0.001, Mann-Whitney).
CONCLUSION: Both techniques showed deviations comparable to previous in-vitro studies of digitally manufactured occlusal splints. Less deviations were found in posterior areas of the dental arch with milled manufacturing.
CLINICAL RELEVANCE: Manufacturing of removable occlusal splints with CAD/CAM appears to be a precise and comfortable option.