摘要：

目的： 探究应用多模态数据融合引导完成复杂数字化种植和全口咬合重建的可行性。方法： 对一牙列重度磨耗伴牙列缺损的患者，获取并整合其口内扫描（intraoral scanning，IOS）、口外面部扫描（extral-oral face scanning，EOS）、锥形束CT (cone beam computed tomography，CBCT)及下颌运动等口颌系统的多模态数据，融合构建出四维虚拟牙科患者（virtual dental patient，VDP）。在四维VDP的引导下进行数字化种植和全口咬合重建，使用光学定位的下颌运动系统获取动态咬合数据，利用计算机辅助设计和计算机辅助制造（computer-aided design and computer-aided manufacturing，CAD/CAM）设计制作出最终修复体，完成全口咬合重建修复，并进行客观性评估。结果： 该病例取得较好的修复治疗效果，患者对美观和功能满意，口颌系统健康、舒适。客观性评估数据显示，咬合重建后，患者牙尖交错位(intercuspal position，ICP)时的静态咬合和前伸、侧方运动时的动态咬合都得到了明显的改善，在前牙美学区和后牙功能区都取得了满意的治疗效果。结论： 应用多模态数据融合引导完成复杂数字化种植和全口咬合重建具备可行性，值得推广。

关键词: 牙列重度磨耗, 虚拟牙科患者, 数字化种植, 咬合重建, 动态咬合

Abstract:

Objective: To explore the feasibility of applying multimodal data fusion to guide complicated digital implant restoration and full-mouth occlusal reconstruction.Methods: For a patient with severely worn dentition and dentition defects, the multimodal data of her oral and maxillary system were obtained by intraoral scanning (IOS), extral-oral face scanning (EOS), cone beam computed tomography (CBCT) examination and jaw movement, which can be integrated to create a four-dimensional virtual dental patient (VDP) by fusion. Digital implant restoration and full-mouth occlusal reconstruction were conducted under the guidance of the four-dimensional VDP. The dynamic occlusal data was obtained using the optically positioned mandibular motion system, and the final restoration was designed and manufactured by computer-aided design and computer-aided manufacturing (CAD/CAM). Finally, the full-mouth occlusal reconstruction was completed and we have given an objective evaluation.Results: The case gets a good restoration effect. The patient is satisfied with aesthetics and functionality of full-mouth occlusal reconstruction, with her oral and jaw system healthy and comfortable. As the objective evaluation showed, both static occlusion in intercuspal position (ICP) and dynamic occlusion during forward movement and lateral movement had been significantly improved, and satisfactory therapeutic results had been achieved in both the aesthetic area of the anterior teeth and the functional area of the posterior teeth.Conclusion: It is feasible to conduct complicated digital implant restoration and full-mouth occlusal reconstruction guided by multimode data fusion, which is worth promoting.

Key words: severely worn dentition, virtual dental patient, digital implant restoration, occlusal reconstruction, dynamic occlusion

中图分类号: 

• R782