一种数字化全口义齿的临床疗效评价

目的: 比较计算机辅助设计与制造(computer aided design/computer aided manufacturing,CAD/CAM)技术制作的数字化全口义齿与传统方法制作的全口义齿的临床疗效。方法: 纳入20例无牙颌患者,通过前瞻性、单盲、自身对照临床实验,每人分别采用功能易适性数字化义齿(functional suitable denture, FSD)制作系统及传统方法制作全口义齿。义齿完成后,首先戴用传统全口义齿, 3个月后交换戴用数字化全口义齿。患者于修复前、修复后第2周、第1个月、第2个月、第3个月填写无牙颌口腔健康影响量表-20(oral health impact profile edentulous,OHIP-20E)和义齿满意度视觉模拟评分量表(visual analogue scale,VAS)。于两副义齿戴用后的第3个月,分别进行咀嚼效率测试。结果: 20例患者在戴牙后第3个月,FSD全口义齿VAS评分在总体满意度、易清洁性、发音、美观、稳定、口腔状况这6个方面均值均高于传统全口义齿,而在舒适、咀嚼能力、嚼碎功能这3个方面VAS评分的均值与传统全口义齿基本持平,但差异无统计学意义(P>0.05);FSD全口义齿OHIP-20E评分在各个方面的均值均高于传统全口义齿,其中功能受限、心理不适、总评分这3个方面评分差异有统计学意义(P<0.05);咀嚼效率测量结果为,FSD全口义齿平均咀嚼效率(1.20±0.54)高于传统全口义齿的平均咀嚼效率(1.16±0.53), 差异无统计学意义(P=0.691)。结论: 本研究评价的数字化全口义齿的疗效与传统全口义齿相同,在患者满意度及口腔相关生活质量评价方面都展现出相同的治疗效果。     

数字化全口义齿个别托盘制作与临床应用时间评价

目的：比较三维打印数字化无牙颌个别托盘与传统无牙颌个别托盘的技工制作用时及临床操作用时,从临床时间花费角度对数字化个别托盘进行适用性验证。方法： 招募20名无牙颌患者进行前瞻性、单盲、自身随机对照临床试验,每人均采用北京大学口腔医院功能易适性数字化全口义齿（functional suitable denture, FSD）系统修复方式及传统全口义齿修复方式制作无牙颌个别托盘,将利用两种方式制作的个别托盘制取终印模后制作全口义齿,记录技工制作用时及临床操作用时。结果： 三维打印数字化无牙颌个别托盘与传统无牙颌个别托盘的制作平均人工用时分别为（28.6±2.9） min、（31.1±5.7） min,两者差异有统计学意义（P<0.05）。分别用三维打印数字化无牙颌个别托盘与传统无牙颌个别托盘制取终印模的临床操作平均用时为（23.4±11.5） min、（25.4±13.0）min,两者差异有统计学意义（P<0.05）。结论： 三维打印数字化无牙颌个别托盘的技工制作用时及临床操作用时均小于传统无牙颌个别托盘,采用三维打印数字化无牙颌个别托盘制作全口义齿能够节约技工的制作时间及临床操作用时,且由于其不需要灌注初印模,可节省印模材料及模型材料,在全口义齿修复治疗中,是值得临床推广的制作无牙颌个别托盘的方式。     

功能易适数字化全口义齿的自主创新研发

SUMMARY Fabrication of conventional complete dentures involves a complex restoration method, requiring significant time and typically involving primary impressions, definitive impressions, jaw relation records, clinic try-in, and complete denture placement, which has been used for nearly a century without change. A novel digital system named Functionally Suitable Denture (FSD) was researched and deve-loped so as to reduce clinical steps, operation difficulties and errors of complete denture restoration. It pioneered a unique diagnostic complete denture aided by computer aided design (CAD) & 3D printing, by which, the functional impression, jaw relation, and try-in (3 steps) were simplified to 1 step, thus the number of visits to the dentist was reduced by 2 times. Moreover, for the first time, it put forward a CAD software of template matching based on the expert design, which was an efficient and intelligent design scheme, and the excellent denture experts' experience and skills could be inherited and iterated. The system included the 3D scanner with appropriate accuracy and high efficiency, the CAD software, the special 3D printer and process software, and the innovative clinical operation process. The Patent Cooperation Treaty (PCT) patent international search report showed that all the 15 claims of the technology were of novelty, creativity and industrial utility. All the digital products were independently developed and made by Peking University School and Hospital of Stomatology, China. The design and manufacture process of denture prosthesis was fast, simple and accurate. At the same time, personalized functional and aesthetic matching of the patients after wearing prosthesis was realized. It effectively solved the global problems of "slow, difficult and inaccurate" of the traditional manual technology of complete denture, and brought good news to edentulous patients. Compared with the traditional complete denture treatment, FSD system has a wide range of applications for different types of edentulous patients, including those with severe resorption of the alveolar ridge or a high occlusal force. Furthermore, the low-cost of 3D printers, compared with expensive milling machines, may make the approach more accessible. This review describes that our research is related to the development of the FSD system, including multi-source data acquisition technology, three generations of complete denture design software, 3D printing systems of individual tray and complete denture pattern, the clinical and laboratory operation process of the FSD system.     

功能易适数字化全口义齿的自主创新研发

SUMMARY Fabrication of conventional complete dentures involves a complex restoration method, requiring significant time and typically involving primary impressions, definitive impressions, jaw relation records, clinic try-in, and complete denture placement, which has been used for nearly a century without change. A novel digital system named Functionally Suitable Denture (FSD) was researched and deve-loped so as to reduce clinical steps, operation difficulties and errors of complete denture restoration. It pioneered a unique diagnostic complete denture aided by computer aided design (CAD) & 3D printing, by which, the functional impression, jaw relation, and try-in (3 steps) were simplified to 1 step, thus the number of visits to the dentist was reduced by 2 times. Moreover, for the first time, it put forward a CAD software of template matching based on the expert design, which was an efficient and intelligent design scheme, and the excellent denture experts' experience and skills could be inherited and iterated. The system included the 3D scanner with appropriate accuracy and high efficiency, the CAD software, the special 3D printer and process software, and the innovative clinical operation process. The Patent Cooperation Treaty (PCT) patent international search report showed that all the 15 claims of the technology were of novelty, creativity and industrial utility. All the digital products were independently developed and made by Peking University School and Hospital of Stomatology, China. The design and manufacture process of denture prosthesis was fast, simple and accurate. At the same time, personalized functional and aesthetic matching of the patients after wearing prosthesis was realized. It effectively solved the global problems of "slow, difficult and inaccurate" of the traditional manual technology of complete denture, and brought good news to edentulous patients. Compared with the traditional complete denture treatment, FSD system has a wide range of applications for different types of edentulous patients, including those with severe resorption of the alveolar ridge or a high occlusal force. Furthermore, the low-cost of 3D printers, compared with expensive milling machines, may make the approach more accessible. This review describes that our research is related to the development of the FSD system, including multi-source data acquisition technology, three generations of complete denture design software, 3D printing systems of individual tray and complete denture pattern, the clinical and laboratory operation process of the FSD system.     

无牙颌患者数字化方法制作全口义齿的临床疗效

目的 对比无牙颌患者制作全口义齿数字化方法与传统方法的临床疗效.方法 选取34例无牙颌患者随机分为两组,数字组采用数字化方法修复全口义齿,传统组采用传统方法修复全口义齿,对比两组修复效果并对结果进行统计学分析.结果 修复后1月内,数字组义齿压痛点总个数比传统组少,差异有统计学意义(P＜ 0.001);修复后1个月,数字...     

无牙颌患者数字化方法制作全口义齿的临床疗效

  目的  对比无牙颌患者制作全口义齿数字化方法与传统方法的临床疗效。   方法   选取34例无牙颌患者随机分为两组，数字组采用数字化方法修复全口义齿，传统组采用传统方法修复全口义齿，对比两组修复效果并对结果进行统计学分析。   结果  修复后1月内，数字组义齿压痛点总个数比传统组少，差异有统计学意义（P < 0.001）；修复后1个月，数字组咀嚼效率比传统组高，差异有统计学意义（P < 0.05）；修复后6个月，数字组下牙槽骨前牙、后牙区牙槽骨骨吸收量比传统组少，差异有统计学意义（P < 0.05）；修复后1周、2个月，数字组在义齿使用舒适感、佩戴稳定性和咀嚼能力方面评分比传统组高，差异有统计学意义（P < 0.05），义齿美观性、发音清晰度评分差异无统计学意义（P > 0.05）。  结论  无牙颌患者使用数字化全口义齿临床效果良好；数字化全口义齿在减轻患者疼痛，减少牙槽骨吸收，提升佩戴舒适感、增强佩戴稳定性、提高咀嚼效率方面具有优势，值得推广。     

BPS全口义齿修复的临床研究

目的：通过运用BPS法观察全口义齿修复的临床效果.方法：搜集无牙颌患者102例,其中52例采用传统方法制作全口义齿,50例采用BPS法制作全口义齿,对两组义齿的修复效果进行对比.结果：BPS组在基托边缘伸展比传统组更为合理与舒适,而且更为准确地维持颌位关系.结论：与传统方法制作全口义齿相比,BPS法制作的全口义齿能够很好的地恢复天然牙的形态和功能.     

全可调(牙合)架制作全口义齿的临床分析

目的:观察全可调(牙合)架制作全口义齿的临床疗效.方法:选取无牙糌患者22例,随机分成观察组(全可调糌架组)10例、对照组(简单牙合架组)12例,分别采用全可调(牙合)架和简单牙台架制作全口义齿.结果:全可调(牙合)架制作的全口义齿获得满意的开闭口、前伸和侧方运动中的咬合平衡,达到良好的咀嚼功能,临床初戴时无调磨或少量调磨.结论:使用全可调(牙合)架,全口义齿的修复将获得更满意的形态和功能.     

全口义齿修复失败的原因及处理对策

目的 探析全口义齿修复失败的原因及处理的方法.方法 回顾性分析2017年1月至2020年1月本院收治的50例全口义齿修复失败患者的临床资料,分析全口义齿修复失败的原因,并据此制定具体的处理对策.结果 50例全口义齿修复失败患者中,20例患者因义齿修复体松脱导致(占比40.00％),10例患者因基托折断、断裂导致(占比2...     

腹腔镜下全子宫切除术临床疗效分析

目的：经过比较经腹全子宫切除术和腹腔镜下全子宫切除术的临床效果,探讨腹腔镜下全子宫切除术的临床应用疗效。方法：选择2007年3月～2009年11月经腹全子宫切除术100例,腹腔镜下全子宫切除术100例,对两组术中、术后及恢复情况进行比较。结果：经过比较两组的手术时间、术中出血量、术后肛门排气时间、术后并发症的发生率后,结果显示两组术式的手术时间比较,差异无统计学意义（P〉0.05）,而腹腔镜组的术中出血量、术后肛门排气时间以及术后并发症发生率明显优于腹式组,差异有统计学意义（P〈0.05）,腹腔镜下全子宫切除术的临床疗效明显优于经腹全子宫切除术。结论：腹腔镜下全子宫切除术是一种疗效明显、安全可靠的手术方式,值得在临床广泛开展。     

铸造金属网在全口义齿修复中的临床应用

目的目的观察铸造金属网在全口义齿修复中的临床效果。方法通过对18例全口义齿塑料基托折断的患者采用钴铬合金铸造金属网来提高塑料基托的抗折强度。结果经过一年至三年的随访观察,元一例再发生基托折断现象,患者均表示满意。结论全口义齿塑料基托经过钻铬合金铸造金属网增强其强度后,可有效预防塑料基托折断,延长全口义齿的使用寿命,而且制作工艺简单,费用低,易于推广。     

LBL与PBL结合应用于全口义齿修复教学研究

目的探索全口义齿教学新方法,提高教学效果。方法将49名学生随机分成6组,在全口义齿修复学教学中采用基于课堂的学习（1ecture—basedlearning,LBL）和以问题为基础的学习（problem—basedlearning,PBL）相结合。LBL授课18学时,以教师讲授为主,大班上课,侧重于全口义齿基本理论的介绍。PBL授课6学时,小班上课,以教研组编写的“王老伯新装的全口假牙”教案为蓝本,让学生分组讨论并查阅相关资料,分析全口义齿初戴后可能会出现的问题、相关原因及处理方法,最后总结汇报。通过全口义齿修复学考试和学生PBL授课反馈表两项指标对教学效果进行评价。数据采用百分率描述。结果学生理论考试成绩优良率达到67．35％,合格率达93．88％;77．55％的学生支持PBL授课形式。结论LBL和PBL相结合应用到全口义齿修复教学中获得良好教学效果。     

48例牙槽嵴低平患者全口义齿修复的临床体会

目的探讨牙槽嵴低平患者全口义齿的修复方法、特点和效果。方法对48例牙槽嵴低平的老年患者,通过二次取模,准确地颌位记录,排牙,基托边缘及磨光面做解剖式处理,充分利用唇、颊、舌肌固位,制作全口义齿。结果经过1-5年追踪观察,临床效果良好。一次治疗成功45例（91．7％）,重新制作3例（8．3％）,其中固位不良2例,局部压痛剧烈1例。结论对牙槽嵴低平的老年患者,采取适当的措施可以达到满意的修复效果。     

计算机辅助设计/计算机辅助制作玻璃陶瓷嵌体在Ⅱ类洞修复中的应用研究

目的观察CEREC(瓷睿刻)AC计算机辅助设计/计算机辅助制作(CAD/CAM)系统制作的玻璃陶瓷嵌体修复磨牙Ⅱ类洞的临床效果。方法选取2011年5月至2012年5月沈阳军区总医院口腔门诊收治的牙体缺损需制备Ⅱ类洞患者60例(78颗磨牙),使用CEREC AC CAD/CAM系统制作玻璃陶瓷嵌体,修复后追踪观察3个月、6个月、1年,按照改良美国公共卫生服务标准进行临床评价,并比较修复第1磨牙和第2磨牙缺损的成功率。结果玻璃陶瓷嵌体修复1年成功率达到96.0%,第1磨牙和第2磨牙嵌体修复的成功率比较差异无统计学意义(P>0.05)。结论 CEREC AC CAD/CAM系统制作玻璃陶瓷嵌体修复后磨牙Ⅱ类洞具有较好的临床效果。