
数字化技术在酸蚀症伴重度磨耗患者功能美学缺陷修复中的应用1例
侯玮玮, 郑绪红, 陈晓玲, 蔡蔚靓, 王朝阳, 苏智伟, 赵鹃
数字化技术在酸蚀症伴重度磨耗患者功能美学缺陷修复中的应用1例
Application of digital technology in the repair of functional and aesthetic defects in patients with acid erosion and severe attrition: a case report
牙磨耗、磨损、酸蚀症等多因素导致的非龋性牙体缺损在口腔临床中的发病率呈上升趋势,通常伴随着不同程度的口腔美学缺陷及功能障碍。对其进行全牙列固定修复咬合重建时,不仅要恢复牙列的形态和美观,更要实现咬合关系与整体口颌系统的协调。本文报道1例酸蚀症伴重度磨耗的病例,利用多模态数字化数据(口内扫描、面部扫描、电子面弓、下颌运动轨迹描记等)构建4D虚拟患者,制定全面的修复方案,进行不同牙齿的个性化微创修复,采用唇贴面、颊贴面、
贴面、高嵌体、嵌体、全冠等多种修复体,完成数字化全牙列咬合重建治疗,为该疾病的诊治提供可视化、可全程质控的全局观诊疗策略。
Noncarious lesions, a multifactorial condition encompassing tooth attrition, abrasion, and erosion, have a surge in prevalence and required increased attention in clinical practice. These nonbacterial-associated tooth defects can compromise aesthetics, phonetics, and masticatory functions. When providing full-arch fixed occlusal rehabilitation for such cases, the treatment strategy should extend beyond by restoring dentition morphology and aesthetics. This report details a complex case of erosive dental wear addressed through a fully digital, full-arch fixed occlusal rehabilitation. A 4D virtual patient was created using multiple digital data sources, including intraoral scanning, 3D facial scanning, digital facebow registration, and mandibular movement tracing. With a comprehensive understanding of the masticatory system, various types of microinvasive prostheses were customized for each tooth, including labial veneers, buccal-occlusal veneers, occlusal veneers, overlays, inlays, and full crowns, were customized for each tooth. The reported digital workflow offered a predictable diagnostic and treatment strategy, which was facilitated by virtual visualization and comprehensive quality control throughout the process.
digital technology / erosion / bruxism / occlusal rehabilitation
R783
1 | Van’t Spijker A, Rodriguez JM, Kreulen CM, et al. Pre-valence of tooth wear in adults[J]. Int J Prosthodont, 2009, 22(1): 35-42. |
2 | Kaidonis JA. Oral diagnosis and treatment planning: part 4. Non-carious tooth surface loss and assessment of risk[J]. Br Dent J, 2012, 213(4): 155-161. |
3 | Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines[J]. J Adhes Dent, 2017, 19(2): 111-119. |
4 | 谭建国. 一步一步做好牙列重度磨耗的功能美学重建[J]. 中华口腔医学杂志, 2020, 55(9): 696-700. |
4 | Tan JG. Esthetic and functional rehabilitation of severely worn dentition: step by step[J]. Chin J Stomatol, 2020, 55(9): 696-700. |
5 | Schlichting LH, Resende TH, Reis KR, et al. Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers[J]. J Prosthet Dent, 2016, 116(4): 474-482. |
6 | 金晓婷, 赵维家, 罗洁, 等. 咬合重建: 科学与艺术的结合[J]. 口腔颌面修复学杂志, 2023, 24(1): 1-6. |
6 | Jin XT, Zhao WJ, Luo J, et al. Full-mouth occlusal reconstruction: science and art[J]. Chin J Prosthodont, 2023, 24(1): 1-6. |
7 | Wetselaar P, Lobbezoo F. The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions[J]. J Oral Rehabil, 2016, 43(1): 69-80. |
8 | 谭建国. 牙列重度磨耗的病因和鉴别诊断[J]. 中华口腔医学杂志, 2020, 55(8): 599-602. |
8 | Tan JG. Etiology and differential diagnosis of severely worn dentition[J]. Chin J Stomatol, 2020, 55(8): 599-602. |
9 | Vig RG, Brundo GC. The kinetics of anterior tooth display[J]. J Prosthet Dent, 1978, 39(5): 502-504. |
10 | 谭建国. 牙齿美学修复的美学分析与设计[J]. 中国实用口腔科杂志, 2011, 4(8): 449-450. |
10 | Tan JG. Esthetic analysis and design in dental esthetic rehabilitation[J]. Chin J Pract Stomatol, 2011, 4(8): 449-450. |
11 | 谭建国. 数字化技术在牙列重度磨耗功能美学重建中的应用[J]. 中华口腔医学杂志, 2022, 57(10): 1009-1014. |
11 | Tan JG. Application of digital technology in esthetic and functional rehabilitation of severely worn dentition[J]. Chin J Stomatol, 2022, 57(10): 1009-1014. |
12 | Kordass B, G?rtner C, S?hnel A, et al. The virtual articulator in dentistry: concept and development[J]. Dent Clin North Am, 2002, 46(3): 493-506. |
13 | Lee W, Kwon HB. Vertical repositioning accuracy of magnetic mounting systems on 4 articulator models[J]. J Prosthet Dent, 2018, 119(3): 446-449. |
14 | 孙欣荣, 冯玥, 刘伟才. 多模态数据融合的可视化技术在咬合重建中的应用[J].华西口腔医学杂志, 2022, 40(4): 468-475. |
14 | Sun XR, Feng Y, Liu WC. Application of visualization technology of multimode data fusion in occlusal rehabilitation[J]. West China J Stomatol, 2022, 40(4): 468-475. |
15 | Dawson PE. Functional occlusion: from TMJ to smile design[M]. St. Louis: Mosby, 2007. |
16 | 刘洋. 关于咬合重建的几个重要问题[J]. 华西口腔医学杂志, 2020, 38(4): 357-363. |
16 | Liu Y. Several important issues concerning occlusal reconstruction[J]. West China J Stomatol, 2020, 38(4): 357-363. |
17 | Spear FM. Occlusal considerations for complex resto-rative therapy[M]. McNeill C. Science and practice of occlusion. Kimberley: Quintessence Publishing Co. Inc, 1997. |
18 | Muts EJ, van Pelt H, Edelhoff D, et al. Tooth wear: a sy-stematic review of treatment options[J]. J Prosthet Dent, 2014, 112(4): 752-759. |
19 | Niem T, Youssef N, W?stmann B. Energy dissipation capacities of CAD-CAM restorative materials: a comparative evaluation of resilience and toughness[J]. J Prosthet Dent, 2019, 121(1): 101-109. |
20 | Lawson NC, Bansal R, Burgess JO. Wear, strength, modulus and hardness of CAD/CAM restorative materials[J]. Dent Mater, 2016, 32(11): e275-e283. |
21 | Tian T, Tsoi JK, Matinlinna JP, et al. Aspects of bonding between resin luting cements and glass ceramic materials[J]. Dent Mater, 2014, 30(7): e147-e162. |
22 | Chen C, Trindade FZ, de Jager N, et al. The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses[J]. Dent Mater, 2014, 30(9): 954-962. |
23 | Sasse M, Krummel A, Klosa K, et al. Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic[J]. Dent Mater, 2015, 31(8): 907-915. |
24 | Baldissara P, Monaco C, Onofri E, et al. Fatigue resistance of monolithic lithium disilicate occlusal veneers: a pilot study[J]. Odontology, 2019, 107(4): 482-490. |
25 | Andrade JP, Stona D, Bittencourt HR, et al. Effect of different computer-aided design/computer-aided manufacturing (CAD/CAM) materials and thicknesses on the fracture resistance of occlusal veneers[J]. Oper Dent, 2018, 43(5): 539-548. |
26 | Rebibo M, Darmouni L, Jouvin J. Vertical dimension of occlusion: the keys to decision we may play with the VDO if we know some game’s rules[J]. J Stomat Occ Med, 2009, 2(3): 147-159. |
27 | Feng Y, Zhan L, Sun X, et al. A fully digital workflow to register maxillomandibular relation using a jaw motion tracer for fixed prosthetic rehabilitation: a technical report[J]. J Esthet Restor Dent, 2023, 35(7): 1068-1076. |
28 | 俞懿强, 刘伟才. 口腔固定修复全数字化流程的临床应用现状及问题[J]. 中华口腔医学杂志, 2023, 58(5): 398-403. |
28 | Yu YQ, Liu WC. Current situation and problems of the clinical application of completely digital workflow in fixed prosthodontics[J]. Chin J Stomatol, 2023, 58(5): 398-403. |
/
〈 |
|
〉 |