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两种扫描杆辅助下全牙弓种植固定修复口内扫描精度的比较
富晓娇
蔡征真
史俊宇
赖红昌
作者及单位信息
·
DOI： 10.3760/cma.j.cn112144-20240817-00315
Comparison of the accuracy of two types of scanning bodies for intraoral scanning in complete-arch implant-supported fixed restoration
Fu Xiaojiao
Cai Zhengzhen
Shi Junyu
Lai Hongchang
Authors Info & Affiliations
Fu Xiaojiao
Department of Oral and Maxillofacial Implantology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
Cai Zhengzhen
Department of Oral and Maxillofacial Implantology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
Shi Junyu
Department of Oral and Maxillofacial Implantology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
Lai Hongchang
Department of Oral and Maxillofacial Implantology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
·
DOI： 10.3760/cma.j.cn112144-20240817-00315
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摘要

目的探讨全牙弓种植固定修复过程中常规扫描杆、伞形扫描杆、伞形扫描杆结合辅助杆辅助下口内扫描的精度差异，以期为伞形扫描杆的临床应用提供参考。

方法自主研发1种新型伞形扫描杆以及配套辅助杆。制作带有6个平行种植体复合基台替代体的上颌超硬石膏模型1个。于石膏模型上安装常规扫描杆，采用牙颌模型扫描仪进行模型扫描作为参考数据。将常规扫描杆、伞形扫描杆、伞形扫描杆结合辅助杆分别安装于石膏模型上，由1名主治医师采用口内扫描仪分别重复扫描10次，作为实验组数据（常规扫描杆组、伞形扫描杆组、伞形扫描杆结合辅助杆组）。将实验组数据与参考数据生成的虚拟基台模型进行最佳拟合配准，测量并计算分别代表正确度和精密度的均方根误差（RMSE）值及各实验组基台间距离偏差和角度偏差，以及扫描时间。采用重复测量的方差分析和广义估计方程模型进行统计学分析。

结果伞形扫描杆组和伞形扫描杆结合辅助杆组正确度RMSE值［（48.0±12.6）和（45.9±13.4）μm］和距离偏差［（64.5±60.2）和（63.8±54.4）μm］均显著优于常规扫描杆组［（81.9±23.9）和（90.0±85.2）μm］（均 P<0.05），伞形扫描杆组和伞形扫描杆结合辅助杆组正确度RMSE值和距离偏差差异均无统计学意义（均 P>0.05）。3组精密度RMSE值和角度偏差差异均无统计学意义（均 P>0.05）。伞形扫描杆组和伞形扫描杆结合辅助杆组扫描时间［（54.3±11.8）和（35.8±10.1）s］均显著小于常规扫描杆组［（108.7±38.9）s］（均 P<0.05）。

结论相比常规扫描杆，新型伞形扫描杆在针对全牙弓种植固定修复进行口内扫描时，具有更高的精准度与效率。

牙种植;颌，无牙;口内扫描;精度;数字化口腔医学
ABSTRACT

ObjectiveTo compare the accuracy of intraoral scanning for complete-arch implant-supported fixed prosthesis using umbrella scan bodies (USB) and conventional scan bodies (CSB), providing a reference for the clinical application of umbrella-shaped scanning bodies.

MethodsA new type of umbrella-shaped scanning body and its matching auxiliary bar were independently developed. A maxillary type Ⅳ dental stone model with six parallel implant abutment analogs was fabricated. Conventional scanning bodies were installed on the model, and a laboratory scanner was used to scan the model as reference data. The CSB, USB, and USB combined with an auxiliary bar (U+SB) were installed on the model, respectively. A single attending physician performed intraoral scanning 10 times for each group using an intraoral scanner, serving as test group data (CSB, USB, U+SB). The test data were best-fit aligned with the virtual abutment models generated from the reference data. The trueness and precision of root-mean-square error (RMSE) values, inter-abutment distance deviations, angular deviations, and scanning time were measured and calculated. Repeated measures ANOVA and generalized estimating equation models were used for statistical analysis.

ResultsThe trueness of RMSE values [(48.0±12.6) and (45.9±13.4) μm] and distance deviations [(64.5±60.2) and (63.8±54.4) μm] of the USB and U+SB groups were significantly better than those of the CSB group [(81.9±23.9) and (90.0±85.2) μm] (all P<0.05). There was no significant difference in trueness of RMSE values and distance deviations between the USB group and U+SB group (all P>0.05). There were no significant differences in the precision of RMSE values and angular deviations among the three groups (all P>0.05). The scanning time of the USB group and U+SB group [(54.3±11.8) and (35.8±10.1) s] was significantly shorter than that of CSB group [(108.7±38.9) s] (all P<0.05).

ConclusionsCompared with conventional scanning bodies, the new umbrella-shaped scanning body demonstrates higher accuracy and efficiency for intraoral scanning impressions in complete-arch implant-supported fixed prosthesis.

Dental implantation;Jaw, edentulous;Intraoral scanning;Accuracy;Digital dentistry
Lai Hongchang, Email: mocdef.6ab21ialgnahcgnoh, Tel: 0086-21-53315299
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引用本文

富晓娇,蔡征真,史俊宇,等. 两种扫描杆辅助下全牙弓种植固定修复口内扫描精度的比较[J]. 中华口腔医学杂志,2025,60(03)：267-272.

DOI:10.3760/cma.j.cn112144-20240817-00315

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通过口内扫描获得数字化印模在口腔种植领域应用广泛，单牙和短跨度种植时数字化印模的精度可满足临床应用要求 ［ 1 , 2 ］ 。然而，通过口内扫描获得全牙弓种植固定修复数字化印模仍是临床难点 ［ 3 ］ 。主要因为口内扫描的原理是通过深度相机连续获取多帧图像，利用算法进行拼接，拼接的依据是相邻帧图像间共同的解剖形态信息 ［ 4 ］ 。然而，全牙弓种植固定修复患者口内扫描区域解剖标志相对较少，可增加后续图像配准拼接难度 ［ 5 , 6 ］ ，进而引入较大的误差。此外，口内可移动的软组织在扫描过程中可能因呼吸、吞咽或口腔肌肉的活动而发生位移，从而干扰扫描设备精准捕捉图像 ［ 7 , 8 , 9 ］ 。全牙弓扫描范围广，覆盖整个牙弓，在此扫描跨度下，即使每个小区域的扫描误差较小，但累积的总体误差，可对最终的图像配准拼接结果产生不利影响。因此，全牙弓种植固定修复的口内扫描面临解剖标志稀缺、软组织移动干扰以及扫描跨度大等多重问题，这些问题共同影响口内扫描的准确性。
已有研究显示，通过增加扫描杆等辅助装置，于扫描杆上安装延伸结构，可提高全牙弓种植固定修复口内扫描精度 ［ 10 , 11 ］ 。本课题组一项体外研究对比不同扫描仪在采用扫描杆辅助装置时的精度，结果显示，对于不同的扫描仪，扫描杆辅助装置均可显著提高扫描精度；且临床研究显示，口内扫描结合扫描杆辅助装置与口外摄影测量的距离偏差差异无统计学意义 ［ 12 ］ 。然而，现有的全牙弓种植固定修复的扫描杆大多是在常规种植扫描杆的基础上增加辅助装置 ［ 11 ， 13 , 14 , 15 , 16 ］ ，个别研究针对全牙弓种植口内扫描应用特定扫描杆 ［ 17 ］ 。本课题组结合口内扫描数字化印模的扫描难点，自主设计研发1种新型伞形扫描杆及配套辅助杆，本项研究探讨全牙弓种植固定修复过程中常规扫描杆、伞形扫描杆、伞形扫描杆结合辅助杆辅助下口内扫描的精度差异，以期为伞形扫描杆的临床应用提供参考。
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备注信息
A
赖红昌，Email： mocdef.6ab21ialgnahcgnoh，电话：021-53315299
B

富晓娇：伞形扫描杆的设计、研究的设计和执行、文章撰写；蔡征真：研究执行、数据分析、史俊宇、赖红昌：研究设计、文章修改

C
富晓娇, 蔡征真, 史俊宇, 等. 两种扫描杆辅助下全牙弓种植固定修复口内扫描精度的比较[J]. 中华口腔医学杂志, 2025, 60(3): 267-272. DOI: 10.3760/cma.j.cn112144-20240817-00315.
D
所有作者声明不存在利益冲突
E
中央高校基本科研业务费专项资金 (YG2024QNA24)
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