人工智能正颌手术板的设计与精确性评价

doi:10.12439/kqhm.1005-4979.2024.02.006

摘要/Abstract

摘要：

目的： 建立基于人工智能（artificial intelligence，AI）的正颌外科手术板设计方法，并比较其与普通数字化板的精度差异。方法： 通过相关软件程序建立正颌外科手术板的设计算法，得到可用的板自动设计程序，比较同一病例进行手术板设计所需时间。将40例骨性Ⅱ类错颌畸形患者（20例单颌，20例双颌）咬合模型纳入比较，分别由AI软件和人工数字化软件设计并打印手术板。将同一组模型分别戴入AI板与普通板后扫描获取数字化数据，比较整体偏差与部分牙尖位置偏差。结果： 牙列模型整体偏差分析结果显示，整体偏差均小于0.1 mm，表示AI板与普通板在引导模型就位上未见明显区别；牙尖位置偏差比较显示，AI板与普通板偏差距离均值约为0.10~0.14 mm；使用AI软件在单颌手术[（10.7±2.4）s]和双颌手术[（21.5±3.9）s]板设计中均可极大减少设计所需时间。结论： AI板精度与普通板相比，未见明显差异，同时其能够提升正颌手术板的设计效率。

关键词: 牙颌面畸形, 人工智能, 正颌外科, 数字化外科

Abstract:

Objective: To establish a design program for orthognathic surgical splints based on artificial intelligence (AI), and to compare the precision between the AI splints and manual digital splints. Methods: This research established an AI algorithm for orthognathic surgical splints and obtained the available automatic design program. The time required for designing surgical splints in the same case was compared. Besides, 40 dentition models of patients with skeletal Class Ⅱ malocclusion (20 for mandibular surgery, and 20 for bimaxillary surgery) were included for comparison. The splints were designed by AI program and manual digital software respectively and scanned for the digital data to compare the difference. Results: The overall deviation between the AI and manual digital splints in guiding the positioning of the models was less than 0.1 mm, indicating that there was no significant difference between them. Comparison of cusp position showed that the mean deviation distance between the AI and manual digital splints was about 0.10-0.14 mm. The application of the AI program can greatly reduce the design time in both the mandibular surgery [(10.7±2.4) s] and the bimaxillary surgery [(21.5±3.9) s]. Conclusion: There is no significant difference in accuracy between AI and manual digital splints, and AI program can improve the design efficiency of orthognathic surgical splints.

Key words: dento-maxillofacial deformities, artificial intelligence, orthognathic surgery, digital surgery

中图分类号:

R782

刘志凯, 许春炜, 朱照琨, 刘瑶, 罗恩. 人工智能正颌手术板的设计与精确性评价[J]. 《口腔颌面外科杂志》, 2024, 34(2): 115-121.

LIU Zhikai, XU Chunwei, ZHU Zhaokun, LIU Yao, LUO En. Design and accuracy evaluation of AI orthognathic surgery plates[J]. 《Journal of Oral and Maxillofacial Surgery》, 2024, 34(2): 115-121.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2024/V34/I2/115

图/表 7

图1 AI板的基本要素

Figure 1 Basic elements of AI splints

图2 AI板设计的主要流程

Figure 2 The main process of AI splints design

图3 模型实验坐标系及牙尖标志点 A.U6L与L6L位置示意图；B.U1R与L1R位置示意图；C.U6R与L6R位置示意图。X轴代表左右方向，Y轴代表前后方向，Z轴代表垂直方向，箭头所示为正方向。

Figure 3 The coordinate system and the marking point of cusps in model experiment

图4 骨性Ⅱ类错颌畸形单颌手术下牙列偏差分析

Figure 4 Deviation analysis of mandibular surgery dentition in skeletal Class Ⅱ malocclusion

图5 骨性Ⅱ类错颌畸形双颌手术上下牙列模型偏差分析 A.双颌手术上牙列；B.双颌手术下牙列。

Figure 5 Deviation analysis of bimaxillary surgery dentition in skeletal class Ⅱ malocclusion

表1 骨性Ⅱ类错颌畸形模型牙尖标志点3D差异($\bar{x} \pm s$ )

Table 1 The 3D difference of tooth-cusp position in the skeletal class Ⅱmalocclusion models ($\bar{x} \pm s$ )

参数	d/mm	dX/mm	P值	dY/mm	P值	dZ/mm	P值
单颌
下牙列
L1R	0.106±0.016	0.005±0.039	0.766	0.001±0.050	0.962	0.029±0.084	0.335
L6R	0.104±0.020	0.009±0.041	0.854	0.004±0.401	0.319	0.032±0.086	0.314
L6L	0.099±0.015	0.008±0.045	0.811	-0.003±0.037	0.893	0.026±0.801	0.168
双颌
上牙列
U1R	0.103±0.017	0.003±0.043	0.869	-0.005±0.050	0.783	-0.026±0.080	0.383
U6R	0.096±0.021	0.002±0.030	0.775	-0.011±0.040	0.731	-0.031±0.080	0.349
U6L	0.101±0.025	0.004±0.038	0.891	0.002±0.048	0.864	-0.030±0.082	0.316
下牙列
L1R	0.140±0.027	0.002±0.050	0.712	0.002±0.051	0.743	-0.024±0.124	0.059
L6R	0.136±0.027	-0.003±0.049	0.818	0.003±0.050	0.821	-0.027±0.120	0.052
L6L	0.142±0.023	0.004±0.054	0.783	0.003±0.044	0.874	-0.026±0.127	0.057

表2 AI板与普通板不同手术方案所需制作时间

Table 2 The design time of AI versus manual digital splints needed for different surgical plan

手术方案	制作时间/s
手术方案	普通板	AI板
单颌手术	240.6±30.9	10.7±2.4
双颌手术	410.3±45.6	21.5±3.9

参考文献 21

[1]	胡静, 沈国芳, 刘彦普, 等. 牙颌面畸形诊断与治疗指南[J]. 中国口腔颌面外科杂志, 2011, 9(5): 415-419.
[2]	Deng H, Yuan P, Wong S, et al. An automatic approach to establish clinically desired final dental occlusion for one-piece maxillary orthognathic surgery[J]. Int J Comput Assist Radiol Surg, 2020, 15(11): 1763-1773. doi: 10.1007/s11548-020-02125-y pmid: 32100178
[3]	Elnagar MH, Aronovich S, Kusnoto B. Digital workflow for combined orthodontics and orthognathic surgery[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(1): 1-14. doi: 10.1016/j.coms.2019.08.004 URL
[4]	Rückschloß T, Ristow O, Müller M, et al. Accuracy of patient-specific implants and additive-manufactured surgical splints in orthognathic surgery — a three-dimensional retrospective study[J]. J Craniomaxillofac Surg, 2019, 47(6): 847-853. doi: S1010-5182(18)31145-4 pmid: 30894302
[5]	Du W, Yang M, Liu H, et al. Treatment of hemimandibular hyperplasia by computer-aided design and computer-aided manufacturing cutting and drilling guides accompanied with pre-bent titanium plates[J]. J Craniomaxillofac Surg, 2020, 48(1): 1-8. doi: S1010-5182(18)30965-X pmid: 31884028
[6]	Chen XJ, Li X, Xu L, et al. Development of a computer-aided design software for dental splint in orthognathic surgery[J]. Sci Rep, 2016, 6: 38867. doi: 10.1038/srep38867 pmid: 27966601
[7]	Ilhan B, Lin K, Guneri P, et al. Improving oral cancer outcomes with imaging and artificial intelligence[J]. J Dent Res, 2020, 99(3): 241-248. doi: 10.1177/0022034520902128 pmid: 32077795
[8]	Choi HI, Jung SK, Baek SH, et al. Artificial intelligent model with neural network machine learning for the diagnosis of orthognathic surgery[J]. J Craniofac Surg, 2019, 30(7): 1986-1989. doi: 10.1097/SCS.0000000000005650 URL
[9]	Shan T, Tay FR, Gu L. Application of artificial intelligence in dentistry[J]. J Dent Res, 2021, 100(3): 232-244. doi: 10.1177/0022034520969115 pmid: 33118431
[10]	Chen H, Jiang N, Bi R, et al. Comparison of the accuracy of maxillary repositioning between using splints and templates in 2-jaw orthognathic surgery[J]. J Oral Maxillofac Surg, 2022, 80(8): 1331-1339. doi: 10.1016/j.joms.2022.04.016 URL
[11]	Jolliffe IT, Cadima J. Principal component analysis: A review and recent developments[J]. Philos Trans A Math Phys Eng Sci, 2016, 374(2065): 20150202.
[12]	宋昱, 孙文赟, 陈昌盛. 对数变换主成分分析的图像识别[J]. 西安交通大学学报, 2021, 55(1): 33-42.
[13]	Qin YG, Luo ZQ, Wen L, et al. Research and application of boolean operation for triangular mesh model of underground space engineering—boolean operation for triangular mesh model[J]. Energy Sci Eng, 2019, 7(4): 1154-1165. doi: 10.1002/ese3.v7.4 URL
[14]	Sheng B, Li P, Fu HB, et al. Efficient non-incremental constructive solid geometry evaluation for triangular meshes[J]. Graph Models, 2018, 97: 1-16. doi: 10.1016/j.gmod.2018.03.001 URL
[15]	Yuan Y, Wu F, Hu QX, et al. The research of an optimized boolean operation algorithm for skull defect mending[C]// 7th Asian-Pacific Conference on Medical and Biological Engineering. Berlin, Heidelberg: Springer, 2008: 725-728.
[16]	Ye NS, Wu TT, Dong T, et al. Precision of 3D-printed splints with different dental model offsets[J]. Am J Orthod Dentofacial Orthop, 2019, 155(5): 733-738. doi: 10.1016/j.ajodo.2018.09.012 URL
[17]	Song KG, Baek SH. Comparison of the accuracy of the three-dimensional virtual method and the conventional manual method for model surgery and intermediate wafer fabrication[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(1): 13-21. doi: 10.1016/j.tripleo.2008.06.002 URL
[18]	Shqaidef A, Ayoub AF, Khambay BS. How accurate are rapid prototyped (RP) final orthognathic surgical wafers? A pilot study[J]. Br J Oral Maxillofac Surg, 2014, 52(7): 609-614. doi: 10.1016/j.bjoms.2014.04.010 pmid: 24933576
[19]	Lauren M, McIntyre F. A new computer-assisted method for design and fabrication of occlusal splints[J]. Am J Orthod Dentofacial Orthop, 2008, 133(4 Suppl): S130-S135. doi: 10.1016/j.ajodo.2007.11.018 URL
[20]	Marcel R, Reinhard H, Andreas K. Accuracy of CAD/CAM-fabricated bite splints: Milling vs 3D printing[J]. Clin Oral Investig, 2020, 24(12): 4607-4615. doi: 10.1007/s00784-020-03329-x
[21]	Hu P, Li JY, Du W, et al. The drilling guiding templates and pre-bent titanium plates improves the operation accuracy of orthognathic surgery with computer-aided design and computer-aided manufacturing occlusal splints for patients with facial asymmetry[J]. J Craniofac Surg, 2019, 30(7): 2144-2148. doi: 10.1097/SCS.0000000000005656 pmid: 31232991

选择文件类型/文献管理软件名称

选择包含的内容