个体化3D打印种植导板在多牙种植中的临床应用

目的:对3D打印种植导板和传统种植导板在多牙缺失种植中的效果进行观察,并评价患者的满意度.方法:30例(83颗牙)缺牙需种植的患者,用随机数字表法分为传统种植导板组(CIT组,15例,42颗牙)和3D打印种植导板组(TDPIT组,15例,41颗牙),CIT组患者采用传统种植导板,TDPIT组患者采用3D打印种植导板,比较2组患者植入种植体的颈部和尖部偏离值、种植体角度偏离值及角度满意度,术后1年牙周袋探诊深度、骨吸收情况及种植成功率.通过满意度问卷调查,比较2组患者对牙种植效果的满意度.采用SPSS19.0软件包对数据进行统计学分析.结果:TDPIT组种植体颈部和尖部在近远中向、颊舌向和垂直向3个方向的偏离值以及在近远中向和颊舌向2个方向的平均角度偏离值均显著小于CIT组(P＜0.05),且TDPIT组种植体在近远中向和颊舌向2个方向的角度满意度显著高于CIT组(P＜0.05).2组患者术后1年种植体牙周袋探诊深度及骨吸收情况无显著差异(t=1.144,P=0.256;t=1.063,P=0.291).2组患者术后3个月和6个月种植成功率无显著差异(P＞0.05),但术后随访9个月和1年,TDPIT组种植成功率显著高于CIT组(90.48％:100％,x2=4.102,P=0.043).满意度问卷调查显示,TDPIT组患者对种植的满意度显著高于CIT组(86.67％:53.33％,x2=3.968,P=0.046).结论:3D打印种植导板植入的种植体精度、种植成功率和患者满意度优于传统种植导板,适合推广应用.     

3D打印铝合金种植手术导板准确度的体外评价

目的 在体外树脂模型上设计并模拟种植体植入实验，分析比较一种新型铝合金材质种植导板与传统树脂导板的准确度差异。方法 选取一名肯氏III类牙列缺损患者并制取硅橡胶印模，灌制超硬石膏模型后使用口内扫描仪扫描，设计并打印20个树脂模型。将患者的锥束计算机断层扫描（CBCT）数据导入软件（3Shape Implant Studio 2019）并规划该患者的种植方案，设计种植导板。使用3D打印机分别制作树脂与铝合金材质手术导板各一个。通过全程引导手术将种植体植入模型中，植入后拍摄术后CBCT。在软件中测量术后CBCT图像与原治疗计划图像，在近远中面和唇腭面分析种植体相对于原设计在三维线性以及角度上的准确度差异。结果 种植体在金属导板引导下的线性偏差分别为近中（0.51±0.63）mm，远中（0.49±0.58） mm，唇向（1.14±1.40） mm，腭向（1.15±1.42） mm；垂直向（2.09±0.84） mm。近远中角度和唇腭侧角度的角度偏差分别为（1.41°±0.81°）和（1.78°±1.03°）。种植体在垂直向的偏差与近远中角度、唇腭侧角度偏差与树脂导板引导下的种植体偏差有统计学...     

3D打印种植导板在前牙区不同术式的精度比较

目的 比较3D打印种植导板引导前牙牙种植在不同术式下的精度。方法 选择21例（32个牙位）牙缺失患者,制作仿真翻瓣与不翻瓣颌骨模型,分为翻瓣组（FP组）与不翻瓣组（FPS组）,分别设计制作牙种植导板,比较两组牙种植体实际位置与术前规划在顶端、底端、垂直向距离的偏差值和角度偏差值。采用SPSS 19.0软件对数据进行统计学分析。结果 FPS组与FP组种植体顶端、底端、垂直向距离偏差值和角度偏差值的差异均有统计学意义（P<0.05）;与FPS组相比,FP组偏差值更小,精度更高。结论 3D打印种植导板可提高牙种植的精确性,翻瓣与不翻瓣的不同术式对牙种植精度有一定的影响,临床医生可根据实际情况合理选择术式。     

3D打印种植导板在前牙区不同术式的精度比较

目的 比较3D打印种植导板引导前牙牙种植在不同术式下的精度。方法 选择21例（32个牙位）牙缺失患者,制作仿真翻瓣与不翻瓣颌骨模型,分为翻瓣组（FP组）与不翻瓣组（FPS组）,分别设计制作牙种植导板,比较两组牙种植体实际位置与术前规划在顶端、底端、垂直向距离的偏差值和角度偏差值。采用SPSS 19.0软件对数据进行统计学分析。结果 FPS组与FP组种植体顶端、底端、垂直向距离偏差值和角度偏差值的差异均有统计学意义（P<0.05）;与FPS组相比,FP组偏差值更小,精度更高。结论 3D打印种植导板可提高牙种植的精确性,翻瓣与不翻瓣的不同术式对牙种植精度有一定的影响,临床医生可根据实际情况合理选择术式。     

3D打印导板在上前牙种植中的精度评价

目的:评价3D打印导板在上前牙种植的精确度,探讨其临床效果。方法:选取2017年6月—2018年6月在青岛大学附属医院口腔种植科行上前牙区种植手术的60例患者,采用随机数字表法随机分为G组（导板组）和R组（常规组）,每组30例,均在术前拍摄锥形束CT（CBCT）,应用“Dentiq Guide种植导板软件”进行设计。G组制作3D打印导板辅助种植手术,R组行常规种植手术。术后即刻拍摄CBCT,应用“Dentiq Guide种植导板软件”将术前、术后CT重叠,测量术前设计与种植体实际位置差异,采用SPSS 24.0软件包对所得数据进行统计分析。结果:G组共植入46颗种植体,测量偏差角度(2.34±1.03)°,顶部(0.63±0.38)mm,根尖部(0.71±0.38)mm,深度(0.41±0.40)mm;R组共植入43颗种植体,测量偏差角度(6.72±3.65)°,顶部(1.59±0.35)mm,根尖部(2.05±0.92)mm,深度(0.77±0.63)mm。2组在角度、顶部、根尖部、深度的差异均有统计学意义（P<0.05）。结论:应用3D打印导板辅助上前牙种植手术,可提高手术精确度,满足种植修复需要,践行以修复为导向的精确种植理念。     

3D打印个性化模型联合数字化外科导板在埋伏牙拔除术临床教学中的应用#br#

埋伏牙拔除术作为口腔颌面外科专业临床训练项目之一,是实习医生必须掌握的一项复杂手术技能。由于埋伏牙一般与邻牙牙根、神经等重要解剖结构关系密切,使用传统手术拔除的方法对术者临床操作要求较高,需要准确判断埋伏牙的位置。而实习医生由于临床经验不足,常发生定位不精确而导致手术时间过长、创伤过大甚至发生邻牙损伤等并发症。因此,在埋伏牙拔除术的教学培训过程中,术前进行充足的模拟训练十分必要。本研究联合运用数字化外科导板和3D打印技术制备仿真教学模型,并以此模型辅助实习医生精确了解埋伏牙的形态、位置和方向,进而决定开窗位置、去骨范围,并最终顺利拔除埋伏牙。其中,数字化外科导板能有效提高实习医生在训练拔除埋伏牙手术过程中的准确性,降低邻牙及附近神经血管损伤的概率。而3D打印个性化模型能直观地模拟埋伏牙的形态及其在牙槽骨中的位置,便于实习医生精准定位埋伏牙,迅速积累临床经验并掌握拔除技巧。该教学模型有助于埋伏牙虚拟拔除手术的训练,其设计符合埋伏牙的临床特征,能有效提高实习医生的临床动手能力,适合推广到医学院校用于临床教学。     

3D打印技术在钙化根管治疗的应用

钙化根管的治疗是牙体牙髓疾病临床治疗中的重要研究项目,建立正确有效的根管疏通路径是解决钙化根管的关键步骤.传统的根管治疗术,难以准确定位并快速获取钙化根管通路,易发生根管壁穿孔、台阶形成、器械分离甚至根折等一系列并发症.随着数字化技术日益发展与成熟,3D打印技术(3D Printing Technology)被应用于钙...     

3D打印临时冠在后牙游离缺失种植修复中的应用

目的 观察3D打印临时冠在后牙连续缺失种植修复中的临床应用效果.方法 选择2019—2020年在我院就诊的双侧后牙游离缺失患者共50例,植入同一种植体系统,种植修复时,患者随机分为2组,每组25例,分别为对照组及试验组.对照组为直接完成组,根据印模及咬合硅橡胶完成最终修复体制作.试验组为临时冠组,采用3D打印先制作临时...     

3D printing restorative materials using a stereolithographic technique: a systematic review

ObjectiveTo present through a systematic review a qualitative analysis of studies published on stereolithography-based 3D printing of restorative materials and their clinical applicability.MethodsThe literature search was conducted based on the question: “What is the state-of-the-art of available restorative materials for 3D printing based on stereolithography?" Online search was conducted in three databases (MEDLINE/PubMed, Scopus and Web of Science) with no restriction for year of publication. Data are reported based on PRISMA, including publication details such as authors and their countries, year and journal of publication, and study design. The synthesis is focused on describing the dental restorative materials and properties evaluated, applied methods, 3D printers used and clinical applicability.ResultsStudies that fit the inclusion criteria were performed in Asia (21), Europe (16) and USA (10), mostly using polymer-based restorative materials (38) for 3D printing constructs. Stereolithographic-printed ceramic-based restorative structures were evaluated by 9 studies. Many studies reported on dimensional accuracy (14), strength (11) and surface morphology (9) of the printed structures. Antibacterial response, cytotoxicity, internal and marginal fit, fracture and wear resistance, density, viscosity, elastic modulus, hardness, structural shrinkage and reliability, degree of conversion, layer cure depth, fatigue, and color were also evaluated by the included studies. Many of them (11) published a proof of concept as an attempt to demonstrate the clinical feasibility and applicability of the technology to print restorative materials, but only 5 studies actually applied the 3D printed restorative structures in patients, which highlights an increasing interest but limited early-stage translation.SignificanceThe fast expansion of stereolithographic-based 3D printing has been impressive and represents a great technological progress with significant disruptive potential. Dentistry has demonstrated an incredible willingness to adapt materials, methods and workflows to this promising digital technology. However, esthetic appearance, wear resistance, wet strength and dimensional accuracy are the main current clinical limitations restricting the progression to functional part production with 3D printing, which may explain the absence of clinical trials and reports on permanent/definitive dental restorative materials and structures.     

口腔修复用金属三维打印件中夹杂物和孔隙率问题分析

目的 探讨口腔修复用金属三维打印件中夹杂物和孔隙率不合格原因，为三维打印口腔金属修复体的加工制作过程控制提供参考。方法 选择44批次钴铬合金和钛合金激光选区熔化（SLM）修复体3D打印件，在金相显微镜下放大100倍测定夹杂物和孔隙的面积分数，分析打印件的孔隙特征和产生不合格的原因。结果 夹杂物和孔隙的面积分数>2.8%的有16批次，不合格率为36.4%。44批次检测样品中未见明显夹杂，不合格均由孔隙面积分数超过2.8%导致。结论 目前口腔修复体加工制作行业对数字化3D打印技术的掌握尚不成熟，加工工艺技术有待进一步提高。     

数字化导板辅助显微根尖手术精确性的临床对照研究

目的 研究数字化导板辅助显微根尖外科手术的精确性.方法 选择就诊于我院需进行显微根尖手术的受试者20例,术前行CBCT扫描,按照随机对照原则分为两组,试验组进行根尖周病变的可视化三维模型建模、手术模拟并设计打印手术导板,在导板引导下手术,对照组进行常规手术评估设计完成手术.两组手术均由同一治疗小组完成.术后拍摄小视野C...     

3D打印技术在口腔颌面修复中的应用

3D打印及其相应计算机辅助医疗模拟技术能根据患者需要,快速制备适合不同患者个性化要求的生物医用材料,并能对材料的微观结构进行精确控制,以精确修复病变组织或器官,并可通过相应的计算机软件辅助进行口腔颌面外科手术模拟操作等,改进治疗方法,提高医疗质量。因此,这种新兴技术在生物医学领域中的应用,尤其在生物医用材料开发、生物组织工程技术中的应用具有独特的优势。本文通过查阅近年来3D打印技术在口腔颌面修复领域中的相关文献,以综述3D打印技术在该领域的应用动态及其进展。     

Application of the 3D digital ostectomy template (DOT) in mandibular angle ostectomy (MAO)

Background

Mandibular angle ostectomy (MAO) is a standard approach in reconstruction of facial contour that is commonly used in East Asian patients with prominent mandibular angles (PMA). MAO is commonly performed via an intraoral approach to reduce scar visibility and risk of facial nerve injury. Since this intraoral approach for MAO has limited visual guidance during the procedure, plastic surgeons often perform the operation based on personal clinical experience. Therefore, we designed a 3D digital ostectomy template (DOT) for guidance during surgery to improve the accuracy and safety of MAO.

3D打印美学模板冠边缘适合性的初步研究

目的 研究3D打印制作临时美学模板的可行性,并比较其与DMG Luxatemp、自凝树脂制作的美学模板的冠边缘适合性。 方法 按统一牙体预备标准对3个上颌树脂牙标准模型分别进行2颗、4颗、6颗牙体预备,并翻制超硬石膏模型各26个。分别用3D打印、DMG Luxatemp、自凝树脂制作两联冠、四联冠、六联冠各5个,通过硅橡胶间隙复制法并在体视显微镜下放大40倍测量各组冠边缘间隙值。采用SPSS 20.0软件对实验数据进行统计分析。 结果 3D打印组、DMG Luxatemp组、自凝树脂组制作的两联冠、四联冠、六联冠边缘间隙值之间存在显著性差异（P＜0.05）。3D打印组边缘间隙值分别为（78.02±0.65）、 （78.04±0.66） 、 （78.48±0.65）μm。DMG Luxatemp组边缘间隙值分别为（101.24±1.61）、（100.71±1.60）、（99.37±1.38）μm。自凝组边缘间隙值分别为（154.62±9.69）、（155.76±4.39）、（152.34±5.21）μm。间隙最小,适合性最好的是3D组,其次是DMG Luxatemp组,间隙最大,适合性最差的是自凝组。而同种方法制作的两联冠、四联冠、六联冠边缘间隙值之间无统计学差异。 结论 3D打印制作的临时美学模板冠边缘适合性显著优于DMG Luxatemp和自凝树脂。     

3D打印技术在口颌面治疗中的应用进展

研究3D打印技术的发展其及在口颌面治疗中的应用现状.查阅PubMed、Web of Science、Elsevier ScienDirect、万方、维普期刊、中国知网等数据库.3D打印技术首先被应用于工业工程领域,随后被推广到临床医学领域,主要涉及骨科、心胸外科、口腔科、神经外科等.3D打印技术对于制造大规模的个性化产品具有划时代的意义,其在口腔医学上的应用将成为一种必然趋势.     

Monomer release from surgical guide resins manufactured with different 3D printing devices

ObjectivesThe aim of this study was to assess the post curing monomer release of resins applicable for 3D printing of surgical implant guides in dependency of printing technique and storing media using high performance liquidchromatography.Material and methodsSpecimens of Nextdent SG, Freeprint Splint, Fotodent Guide, 3Delta Guide, and V-print SG (n = 4) were additively manufactured with the corresponding DLP/SLA printing devices (Rapidshape D20II, Form2, Solflex350). Postprocessing was done according to the manufacturer’s specifications. Subsequently, samples were eluted in methanol and water for 3 days and analyzed with gas chromatography/mass spectrometry (GC/MS).ResultsA total of twelve different substances released from the tested resin materials. The highest eluted concentration for MMA in methanol was 20.27 ± 8.60 μg/mL followed by 12.66 ± 3.38 μg/mL of HPMA. HEMA was found at concentration of 11.17 ± 2.43 μg/mL in methanol and 1.15 ± 0.11 μg/mL in water. TPGDA and TEGDMA reached maximum concentration in methanol of 4.29 ± 0.54 μg/mL and 5.07 ± 0.93 μg/mL and in water of 0.79 ± 0.19 μg/mL and 0.36 ± 0.14 μg/mL, respectively. Significant difference was found for the material Nextdent SG manufactured on SLA and DLP printing device for THFMA (p = 0.041), TEGDMA (p = 0.026), TPGDA (p = 0.05) and EGDMA (p = 0.06). The amount of monomers released into water did not reach the detection threshold for V-print SG.SignificanceThe study revealed significant influence of the printing technique and resin material on the elution of monomers. The elution in methanol and water was significantly different. While the relative amount of eluted monomers from 3D printed guides is comparable to conventional direct composites and below toxic relevant concentrations, the absolute amount of monomer can rise in a clinic situation due to the size of the guides.