Clinical application effect of digital impression technology in robot-assisted implant crown restoration
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摘要:
目的 在机械臂辅助单颗牙种植后，探讨数字化印模技术的优势及其在临床应用中的适应性。 方法 选择2023年2月—2024年9月于蚌埠医科大学第一附属医院口腔科就诊的30例单颗牙缺失患者。在行种植手术3个月后，采用随机数表法将患者随机分为数字化印模组(15例)和传统印模组(15例)。通过分析印模操作时间、视觉模拟量表(VAS)及修复冠的临床适合性，评价2种印模技术的临床效果；此外，根据种植牙的位置，将患者进一步细分为前牙组、前磨牙组和磨牙组，比较不同修复区域2种印模技术的临床工作效率差异。 结果 相较于传统印模技术[23.15(18.93, 28.00)min]，数字化印模技术更节省时间[19.72(13.00, 25.02)min]，差异有统计学意义(U=49.000，P < 0.01)。在恶心/呕吐、舒适度和操作便利性方面，数字化印模技术获得了更高的患者满意度(P < 0.05)。83.33%(25/30)的患者更倾向于选择数字化印模方法。尽管2种印模技术均能实现良好的冠邻接关系，但数字化印模组咬合调整时间[10.17(3.15, 16.72)min]显著短于传统印模组[18.07(9.17, 24.60)min，U=27.500，P < 0.01]。与前磨牙或磨牙相比，前牙的印模操作时间更长，咬合调整时间明显更短(P < 0.05)。 结论 针对机械臂辅助植入的单颗种植体，数字化印模技术能有效地完成缺牙间隙的修复工作。数字化印模技术在修复冠的咬合调整过程中耗时更短，特别是在前牙区。此外，患者对数字化印模技术的满意度亦高于传统方法。 Abstract:Objective To explore the advantages of digital impression technology and its adaptability in clinical application following single tooth implantation assisted by a manipulator. Methods A total of 30 patients with single tooth loss were selected from the Department of Stomatology at the First Affiliated Hospital of Bengbu Medical University from February 2023 to September 2024. Three months after undergoing implant surgery, the patients were randomly divided into a digital printing module (n=15) and a traditional printing module (n=15) by random number table method. The clinical effects of the two impression techniques were evaluated by analyzing the impression operation time, visual analogue scale (VAS), and the clinical suitability of the restoration crown. Additionally, patients were categorized based on the position of dental implants into anterior teeth, premolar, and molar groups. This was done to compare the clinical work efficiency differences between two impression techniques across various restoration areas. Results Compared to traditional impression technology [23.15 (18.93, 28.00) min], digital impression technology saved more time [19.72 (13.00, 25.02) min], and the difference was statistically significant (U=49.000, P < 0.01). In terms of nausea/vomiting, comfort level and convenience of operation, digital impression technology received higher patient satisfaction (P < 0.05). A majority (83.33%, 25/30) of patients preferred the digital impression method. While both impression techniques could achieve satisfactory crown abutment relationships, the digital group had a significantly shorter occlusal adjustment time [10.17 (3.15, 16.72) min] compared to the traditional group [18.07 (9.17, 24.60)min, U=27.500, P < 0.01]. Furthermore, compared to premolars or molars, anterior teeth required longer impression time, yet the occlusal adjustment time was significantly reduced (P < 0.05). Conclusion For single implant assisted by manipulator, digital impression technology can effectively restore the spaces of missing tooth. However, digital impression technology requires less time for occlusal adjustment of implant-supported crowns, particularly in the anterior teeth area. Additionally, patient satisfaction with digital impression technology is higher than with traditional methods. -
图 1 口腔扫描过程
注：A为去除愈合基台后种植牙列的扫描；B为安装扫描体后扫描；C为对颌牙列扫描；D为两侧咬合记录。
Figure 1. Oral scanning process
表 1 USPHS修复体评价标准
Table 1. Evaluation criteria of USPHS prosthesis
评分 边缘 邻接 1分 修复体边缘不密合，有缺损，探针可完全探及基台中央 邻接过紧，无法就位，或邻接过松，牙线无障碍通过 2分 修复体边缘稍卡探针，但探针无法接触基台中央 邻接略紧，可通过少量调磨就位，或邻接略松，牙线通过力量偏小 3分 修复体边缘光滑，与基台密合，不卡针 邻接密合，无需调磨 
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表 2 不同印模技术、种植牙位的印模操作时间比较
Table 2. Comparison of impression operation times of different impression techniques and dental implant positions
组别 例数(%) 印模时间
[M(P25, P75), min]统计量 P值 印模方式 49.000b 0.008 数字化印模组 15(50.00) 19.72(13.00, 25.02) 传统印模组 15(50.00) 23.15(18.93, 28.00) 牙位 6.138c 0.046 前牙组 9(30.00) 24.25(19.90, 27.73) 前磨牙组 9(30.00) 19.58(13.00, 23.28)a 磨牙组 12(40.00) 20.36(16.40, 28.00)a 牙列 69.500c 0.086 上颌组 17(56.67) 22.20(15.83, 27.73) 下颌组 13(43.33) 19.53(13.00, 28.00) 注：与前牙组比较，aP < 0.05；b为U值, c为H值。
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表 3 数字化印模组与传统印模组单颗牙缺失患者满意度比较
Table 3. Comparison of patients' satisfaction between digital impression group and traditional impression group
问题 患者满意度[M(P25, P75)，分] U值 P值 数字化印模组 传统印模组 请问您是否感到疼痛？ 93.64(70.00, 100.00) 99.22(70.00, 100.00) -0.519 0.604 请问您是否感到焦虑？ 98.80(60.00, 100.00) 95.40(80.00, 100.00) -0.979 0.328 请问您是否出现过呕吐反射/恶心？ 96.50(90.00, 100.00) 91.00(80.00, 100.00) -1.982 0.047 请问您认为舒适度如何？ 95.00(80.00, 100.00) 89.67(80.00, 100.00) -2.122 0.034 请问您是否感到呼吸困难？ 96.92(80.00, 100.00) 99.36(80.00, 100.00) -0.553 0.580 请问您认为本次取模的整体便利性如何？ 95.83(80.00, 100.00) 89.33(70.00, 100.00) -2.132 0.033 请问您对本次治疗时间感觉如何？ 95.46(70.00, 100.00) 96.00(80.00, 100.00) -1.594 0.111
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表 4 不同印模方法、种植牙位的邻接关系、咬合调整时间比较
Table 4. Comparison of abutment relationship and occlusal adjustment times of different impression techniques and dental implant positions
组别 邻接关系(分) 咬合调整时间(min) 例数(%) M(P25, P75) 统计量 P值 例数(%) M(P25, P75) 统计量 P值 印模方式 105.000a 0.720 27.500a 0.001 数字化印模组 15(50.00) 3.00(2.00, 3.00) 15(50.00) 10.17(3.15, 16.72) 传统印模组 15(50.00) 2.00(2.00, 3.00) 15(50.00) 18.07(9.17, 24.60) 牙位 0.537b 0.765 10.982b 0.004 前牙组 9(30.00) 2.00(2.00, 3.00) 9(30.00) 9.17(3.15, 21.02) 前磨牙组 9(30.00) 2.00(2.00, 3.00) 9(30.00) 14.85(3.67, 20.00)c 磨牙组 12(40.00) 3.00(2.00, 3.00) 12(40.00) 17.40(7.27, 24.60)c 牙列 103.000a 0.717 103.500a 0.770 上颌组 17(56.67) 2.00(2.00, 3.00) 17(56.67) 14.90(3.15, 24.60) 下颌组 13(43.33) 3.00(2.00, 3.00) 13(43.33) 13.18(3.67, 21.78) 注：a为U值，b为H值。与前牙组比较，cP < 0.05。
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