技术领域Technical field
本发明属于牙科医疗技术领域，具体涉及到一种复制游离端可摘局部义齿基托的方法。The invention belongs to the field of dental medical technology, and specifically relates to a method for replicating a free-end removable partial denture base.
背景技术Background technique
游离端牙列缺损是指牙弓后部牙齿缺失，远中无天然牙存在的缺牙形式。相较于种植修复、固定-活动联合修复而言，可摘局部义齿(RPD)修复适应症范围广、对牙体预备量少且价格低廉，在临床上较为常用。然而，对于下颌远中游离端缺失的患者，RPD修复是临床牙列缺损修复的难点，其受基牙条件和缺失牙牙槽嵴的影响较为明显。一副镶复成功的游离端缺失RPD通常要求义齿支架横跨牙弓获得稳定性，游离鞍基最大限度覆盖无牙区牙槽嵴达到对应力的有效控制。以往文献报道及教科书大多聚焦于义齿支架设计、卡环及卡环组的选择以及采用近中支托等方面，对于印模技术缺乏深入探讨。事实上，当缺牙数目多，余留基牙条件差时，义齿设计通常采用黏膜支持式。彼时，剩余牙槽嵴的黏膜性质起着举足轻重的作用。部分患者义齿承托区黏膜状况欠佳(如：牙槽嵴严重萎缩，黏膜薄而无弹性，存在明显的倒凹骨嵴，承托区边界难以界定等)，对咬合负荷耐受低下，戴义齿后反复出现压痛，黏膜极易损伤，若多次磨改基托，不仅疼痛无明显缓解，反而会因义齿磨改次数过多，导致基托与口腔黏膜组织面密合度下降，最终引起食物嵌塞、义齿不稳定及咀嚼功能障碍。因此，通过制作符合生理要求的基托实现牙槽嵴和基牙间支持力的平衡尤为重要。Free-end dentition refers to the form of missing teeth in the posterior part of the dental arch and no natural teeth in the distal part. Compared with implant restoration and fixed-movable combined restoration, removable partial denture (RPD) restoration has a wide range of indications, requires less tooth preparation and is cheap, so it is more commonly used in clinical practice. However, for patients with missing distal free ends of the mandible, RPD restoration is a difficult point in clinical repair of dentition defects, which is significantly affected by the condition of the abutment teeth and the alveolar ridge of the missing teeth. A successful restoration of a free-end missing RPD usually requires that the denture bracket spans the dental arch to gain stability, and the free saddle base covers the alveolar ridge in the edentulous area to the maximum extent to effectively control stress. Previous literature reports and textbooks mostly focused on the design of denture brackets, the selection of clasps and clasp sets, and the use of mesial denture brackets. In terms of supports and other aspects, there is a lack of in-depth discussion on impression technology. In fact, when there are many missing teeth and the condition of the remaining abutment teeth is poor, mucosa-supported denture design is usually adopted. At that time, the mucosal properties of the remaining alveolar ridge played a pivotal role. Some patients have poor mucosal conditions in the denture supporting area (e.g. severe atrophy of the alveolar ridge, thin and inelastic mucosa, obvious undercut bony ridge, difficulty in defining the boundary of the supporting area, etc.), low tolerance to occlusal loads, and wear and tear. Tenderness occurs repeatedly after dentures, and the mucosa is easily damaged. If the base is grinded and modified many times, not only will the pain not be significantly relieved, but the excessive number of grinding and modification of the denture will lead to a decrease in the closeness between the base and the oral mucosal tissue, eventually causing food Impaction, unstable dentures, and masticatory dysfunction. Therefore, it is particularly important to achieve a balance of support between the alveolar ridge and the abutment teeth by making a base that meets physiological requirements.
虽有多项研究表明，与传统的解剖式印模相比，功能性印模的制取既可取得余留牙的精确解剖形态，又可反映牙周膜、牙槽嵴黏膜和义齿周围肌及系带的功能活动状态，在很大程度上减少了义齿使用过程中下沉、压痛等情况发生，增加了黏膜支持组织的受力及义齿的固位和稳定，并有效提高了患者的咀嚼效率。但其仍存在部分局限性，如该技术只能记录瞬时运动状态、闭口时所做的肌功能运动不一定代表了全部的口腔功能运动、技术敏感性较高、患者的咬合压力难以控制等。一旦义齿基托制作不合适，往往需要在功能应力下进行重衬。以往临床常见的软衬材料(如丙烯酸酯类)，在室温或口腔环境下极易固化，留给患者自主肌功能整塑的时间较短，也无法完整记录患者在语言、咀嚼、吞咽等功能运动中黏膜的形态，需要频繁的临床评估和定期更换，应用受限。近年来，一种由聚合物粉末和液体增塑剂混合而成的黏弹性体-组织调整剂的应用在一定程度上有效地弥补了上述不足。作为一种短期软衬材料，这种材料表现出多种特性：在咀嚼等咬合压力下，具备良好的流动性，临床可塑期具有良好的黏弹性，可保持数天，抵抗黏膜变形，临床不变期增塑剂浸出，材料变硬，弹性稍差一些。基于以上特性，其常被用于变形、发炎及损伤黏膜的调整、动态功能印模制取、义齿空间恢复、临时衬垫/临时修复体制作、临床基托加长前的试验评估、种植体植入术后及牙龈成形术后过渡义齿调整、癌症患者术后封堵创口的阻塞器赝复体制作等。Although many studies have shown that compared with traditional anatomical impressions, the preparation of functional impressions can not only obtain the precise anatomical shape of the remaining teeth, but also reflect the periodontal ligament, alveolar ridge mucosa, and peridenture muscles and systems. The functional activity state of the belt greatly reduces the occurrence of sinking and tenderness during denture use, increases the force of the mucosal supporting tissue and the retention and stability of the denture, and effectively improves the patient's chewing efficiency. However, it still has some limitations. For example, the technology can only record instantaneous movement states, the muscle functional movements performed when closing the mouth may not necessarily represent all oral functional movements, the technology is highly sensitive, and the patient's bite pressure is difficult to control. Once the denture base is made inappropriately, it often needs to be relined under functional stress. In the past, soft lining materials (such as acrylics) that were common in clinical practice were easy to solidify at room temperature or in the oral environment, leaving the patient with a short time for shaping their autonomous muscle functions, and unable to fully record the patient's speech, chewing, swallowing and other functions. The morphology of the mucosa during exercise requires frequent clinical evaluation and regular replacement, and its application is limited. In recent years, the application of a viscoelastic-tissue modifier mixed with polymer powder and liquid plasticizer has effectively made up for the above shortcomings to a certain extent. As a short-term soft lining material, this material exhibits a variety of properties: it has good fluidity under bite pressure such as chewing, has good viscoelasticity during the clinical plasticity period, can last for several days, resists mucosal deformation, and is clinically durable. The aging plasticizer leaches out and the material becomes harder and less elastic. Based on the above characteristics, it is often used for the adjustment of deformed, inflamed and damaged mucosa, making dynamic functional impressions, restoring denture space, making temporary liners/temporary restorations, experimental evaluation before clinical base lengthening, and implant placement. Adjustment of transitional dentures after surgery and gingivoplasty, production of occluder prosthesis for postoperative wound closure in cancer patients, etc.
大量临床实践及研究表明，组织调整剂可大幅改善临床上义齿修复的两大难题，一是疼痛，帮助扭曲的黏膜回弹，平稳地缓冲和分散力，调整损伤的黏膜组织，减少压痛；二是固位，衬垫于义齿组织面，动态性记录黏膜功能状态(如咀嚼、言语、吞咽和副功能等)下义齿基托及边缘的形态、恢复义齿空间。然而，由于其易受唾液及外部因素等影响，黏弹性和解剖结构细节复制能力可随乙醇及增塑剂的渗出明显降低，表面完整性、吸水性和光洁度也在3-4d开始损失，这在某种意义上将增强微生物在材料的黏附，促进细菌和真菌生长，引起念珠菌相关性义齿性口炎；其次，该种材料颜色稳定性欠佳，义齿组织面颜色易变，随着佩戴时间的延长，义齿组织面逐渐变黄，对义齿树脂基托的黏附力也逐渐丧失。因此，组织调整剂不能长久使用，需要在义齿组织面及边缘形态稳定后及时予以替换。A large amount of clinical practice and research have shown that tissue adjusters can greatly improve the two major problems in clinical denture repair. One is pain, help the distorted mucosa to rebound, and smoothly buffer and disperse. force to adjust the damaged mucosal tissue and reduce tenderness; the second is retention, which is padded on the surface of the denture tissue and dynamically records the functional status of the mucosa (such as chewing, speech, swallowing and secondary functions, etc.), the shape of the denture base and edge, Restoring denture space. However, due to its susceptibility to saliva and external factors, the viscoelasticity and ability to replicate anatomical structure details can be significantly reduced with the leakage of ethanol and plasticizers, and the surface integrity, water absorption, and smoothness also begin to lose in 3-4 days. In a sense, this will enhance the adhesion of microorganisms to the material, promote the growth of bacteria and fungi, and cause Candida-related denture stomatitis. Secondly, the color stability of this material is poor, and the color of the denture tissue surface is easy to change. As the wearing time increases, the tissue surface of the denture gradually turns yellow, and the adhesion to the denture resin base is gradually lost. Therefore, the tissue adjuster cannot be used for a long time and needs to be replaced in time after the denture tissue surface and edge shape are stabilized.
目前临床报道的复制方法主要针对全口义齿，对于RPD鲜有研究。这些方法包括：The replication methods currently reported in clinical reports mainly focus on complete dentures, and there are few studies on RPD. These methods include:
(1)热压注塑技术，其工艺流程如图1-4所示。(1) Hot pressing injection molding technology, its process flow is shown in Figure 1-4.
1)将需要复制的个性化义齿基托边缘修整完全，涂布分离剂，应用可逆性油泥型硅橡胶进行围模，超硬石膏灌注，翻制出与原义齿组织面一致的模型(图1)。1) Completely trim the edges of the personalized denture base that needs to be copied, apply a separating agent, use reversible sludge-type silicone rubber to surround the mold, infuse with superanhydrite, and create a model that is consistent with the tissue surface of the original denture (Figure 1 ).
2)将个性化义齿涂布分离剂，装入下半型盒，倒入印模石膏，待石膏凝固后，齿科蜡进行铸道制作，并以不可逆性油泥型硅橡胶复制人工牙列位置，于上半型盒倒入印模石膏，上下装盒、沸水去蜡。打开上半型盒，可见盒内形成原义齿的阴模腔，下半型盒轻轻撬动义齿，将义齿从石膏中完整分离出来(图2)。2) Coat the personalized denture with a separating agent, put it into the lower half of the box, pour the impression plaster, and after the plaster solidifies, use dental wax to make a cast, and use irreversible sludge-type silicone rubber to replicate the position of the artificial teeth. , pour impression plaster into the upper half of the box, pack the upper and lower boxes, and remove the wax with boiling water. Open the upper half of the box, and you can see the female mold cavity of the original denture inside the box. The lower half of the box gently pries the denture and completely separates the denture from the plaster (Figure 2).
3)将个性化义齿牙列与基托分离，牙列复位于上半型盒，将基托注塑树脂通过上、下型盒铸道注射至型盒阴模腔及石膏模型，利用热压注塑成型机进行基托成型，开盒仪器进行开盒(图3)。3) Separate the personalized denture dentition from the base, reset the dentition to the upper half of the mold box, inject the base injection resin through the upper and lower mold box cast channels into the mold box female cavity and plaster model, and use hot pressure injection molding The molding machine performs base molding, and the box opening instrument opens the box (Figure 3).
4)去除下半型盒，放入水中浸泡，使印模石膏充分溶胀后，取出阴模腔内的复制义齿，打磨、抛光，完成义齿制作(图4)。4) Remove the lower half of the box and soak it in water to fully swell the impression plaster. Then take out the replica denture in the female mold cavity and grind and polish it to complete the denture production (Figure 4).
局限性在于：传统手工操作过程繁琐，耗时费力，技术敏感性高，多依赖技师经验，石膏模型灌制产生的人为误差及材料变形不可避免，基托树脂极易发生聚合收缩形变，在一定程度上影响基托与口内黏膜适合性；人工牙与基托分离前，虽有不可逆性油泥型硅橡胶复制人工牙列位置，指导后续排牙，硅橡胶硬化后，或多或少存在偏差，人工牙无法精准复制，椅旁可能需再次调患者等待时间较长等；The limitations are: the traditional manual operation process is cumbersome, time-consuming and labor-intensive, has high technical sensitivity, and relies heavily on the experience of technicians. Human errors and material deformation caused by plaster model pouring are inevitable. The base resin is easily prone to polymerization shrinkage and deformation. To a certain extent, It affects the suitability of the base and the intraoral mucosa; before the artificial teeth are separated from the base, although there is irreversible sludge-type silicone rubber to copy the position of the artificial dentition and guide subsequent tooth arrangement, after the silicone rubber hardens, there will be more or less deviations. The teeth cannot be accurately reproduced, and the chair may need to be adjusted again. Long wait times for patients, etc.;
(2)数字化技术，其工艺流程如图5-7所示。(2) Digital technology, its process flow is shown in Figure 5-7.
1)将需要复制的个性化义齿进行数字化扫描(口内扫描仪或模型扫描仪)，获取其磨光面及组织面的形态信息数据，并利用三维建模软件进行修整，形成完整的个性化义齿扫描文件，文件以STL格式进行存储。1) Digitally scan the personalized denture that needs to be copied (intraoral scanner or model scanner), obtain the morphological information data of its polished surface and tissue surface, and use 3D modeling software to trim it to form a complete personalized denture Scan files and store them in STL format.
2)根据加工方式的不同，可分为数控切削及3D打印两种2) According to different processing methods, it can be divided into two types: CNC cutting and 3D printing.
①数控切削：将STL格式的完整个性化义齿扫描文件导入CAM软件，计算数控切削所需刀具与路径，检查切削方案无误后，计算生成CAM文件，并传输至数控机床，运行数控机床，完成数字化义齿的切削；此方法根据切削树脂盘的不同，又可分为分体切削及一体化切削两种，前者后期需完成基托与人工牙的粘接(图5)，而后者则由于双色树脂盘的特性，后期需在颈缘进行外染色处理，以满足美观要求(图6)；① CNC cutting: Import the complete personalized denture scan file in STL format into the CAM software, calculate the tools and paths required for CNC cutting, and after checking that the cutting plan is correct, calculate and generate the CAM file, and transfer it to the CNC machine tool. Run the CNC machine tool to complete digitization. Denture cutting; this method can be divided into split cutting and integrated cutting according to the different cutting resin discs. The former needs to complete the bonding of the base and artificial teeth in the later stage (Figure 5), while the latter requires two-color resin. Due to the characteristics of the disc, external dyeing treatment is required on the neck edge in the later stage to meet the aesthetic requirements (Figure 6);
②3D打印：将STL格式的完整个性化义齿扫描文件导入数字化切片软件，完成支撑添加，打印参数设定后，数据发送至3D打印机，树脂基托通过光固化技术打印出来，后续粘接成品或打印的树脂牙，完成义齿复制(图7)。目前尚无法完成牙列和基托的多色一体化打印。②3D printing: Import the complete personalized denture scan file in STL format into the digital slicing software, complete the support addition, and set the printing parameters. After the data is sent to the 3D printer, the resin base is printed out through light curing technology, and the finished product is subsequently bonded or printed. The resin teeth are used to complete the denture replication (Figure 7). It is currently not possible to complete multi-color integrated printing of dentition and base.
包括数控切削及3D打印在内的数字化技术虽在一定程度上简化了传统热压注塑的繁杂工艺，且材料没有聚合收缩，残余单体少，无论在制作精度、效率还是组织面适合性方面均表现出较大优势，但与传统方法一样，基托和人工牙的分步加工可能会使牙齿在粘接就位的过程中产生较大的误差，有研究表明，数控切削的全口义齿的咬合面平均偏差可达0.50mm；尽管目前已有切削特制的双色树脂盘可实现义齿的一体化切削制作，但由于人工牙-基托界面轮廓过渡不够自然，后期仍需对颈缘进行外染色处理以满足美观要求，且均需配套的软件，材料利用率低，技术要求及成本均较高。Although digital technologies, including CNC cutting and 3D printing, have simplified the complicated process of traditional hot-press injection molding to a certain extent, the material has no polymerization shrinkage and few residual monomers, and is excellent in terms of production accuracy, efficiency and tissue surface suitability. It shows great advantages, but like the traditional method, the step-by-step processing of the base and artificial teeth may cause large errors in the process of bonding the teeth into place. Studies have shown that the CNC cutting of complete dentures is The average deviation of the occlusal surface can reach 0.50mm; although there are currently two-color resin discs specially cut to realize the integrated cutting and production of dentures, due to the artificial tooth-base interface contour transition is not natural enough, the neck edge still needs to be externally dyed in the later stage Processing to meet aesthetic requirements requires supporting software, low material utilization, and high technical requirements and costs.
更重要的，以上义齿复制技术对于包含金属支架设计的RPD重衬置换可能并不适用。因此，需要探寻一种既能精确复刻义齿组织面及边缘，又能保证义齿咬合面精确度且金属支架及人工牙不受影响的针对RPD个性化义齿基托复制的方法。More importantly, the above denture duplication technology may not be suitable for RPD relining replacement including metal bracket design. Therefore, it is necessary to explore a method for replicating RPD personalized denture bases that can not only accurately reproduce the denture tissue surface and edges, but also ensure the accuracy of the denture occlusal surface without affecting the metal bracket and artificial teeth.
发明内容Contents of the invention
为解决现有技术中存在的问题，本发明提供了一种复制游离端可摘局部义齿基托的方法，力求在简化传统繁杂工艺的同时，节省时长、减少耗材，降低技师劳动强度，减少患者等待周期，规避人为因素和材料变形导致的偏差，提高义齿复制的精确性，提升临床修复效果。In order to solve the problems existing in the prior art, the present invention provides a method for copying the free-end removable partial denture base, striving to simplify the traditional complicated process, save time, reduce consumables, reduce the labor intensity of technicians, and reduce the number of patients. The waiting period avoids deviations caused by human factors and material deformation, improves the accuracy of denture replication, and improves clinical repair effects.
第一方面，本发明提供了一种复制游离端可摘局部义齿基托的方法，也是一种利用数字化技术进行游离端可摘局部义齿(RPD)个性化基托复制的方法，包括以下步骤：In a first aspect, the present invention provides a method for copying a free-end removable partial denture base, and is also a method for using digital technology to copy a free-end removable partial denture (RPD) personalized base, which includes the following steps:
S1、制作支架固定的型盒，将支架复位于所述型盒内的阴模腔，灌注超硬石膏(超硬石膏是一种石膏材料，临床灌注精细模型常用，硬度比普通的白石膏高，操作过程中不容易碎裂)，完成支架的包埋与固定；S1. Make a mold box with a fixed bracket, reset the bracket to the female mold cavity in the mold box, and pour superhard gypsum (superhard gypsum is a gypsum material commonly used in clinical infusion of fine models, and its hardness is higher than ordinary white gypsum. , not easy to break during operation), complete the embedding and fixation of the stent;
S2、使用球钻于石膏模型颊、舌侧及上表面刻球形凹槽各3个；使用柱状车针，分别于石膏模型颊、舌侧表面雕刻不规则波浪线各1条；S2. Use a ball drill to carve 3 spherical grooves each on the buccal, lingual and upper surfaces of the plaster model; use a cylindrical bur to carve 1 irregular wavy line each on the buccal and lingual surfaces of the plaster model;
S3、使用口内扫描仪全面扫描，获取组织面、磨光面、咬合面及包埋石膏等数据信息，导入逆向工程设计软件，修剪多余面片并检查和修复相关数据，得到个性化RPD义齿数据；S3. Use an intraoral scanner to scan comprehensively to obtain data information such as tissue surface, polished surface, occlusal surface, and embedded plaster. Import the reverse engineering design software to trim excess surfaces and inspect and repair relevant data to obtain personalized RPD denture data. ;
S4、使用球钻，分别于需要复制的所述个性化RPD义齿基托的组织面及边缘制作1.5-2mm的定深槽，再进行均匀磨除，磨除后于组织面制作3个定位球凹，利用其与后续打印基托定位球间嵌合关系，实现无模装配；S4. Use a ball drill to make 1.5-2mm fixed-depth grooves on the tissue surface and edge of the personalized RPD denture base that needs to be copied, and then grind them evenly. After grinding, make 3 positioning balls on the tissue surface. Concave, using the fitting relationship between it and the subsequent printing base positioning ball to achieve moldless assembly;
S5、重复步骤S3，得到磨除后个性化RPD义齿数据，通过所述个性化RPD义齿数据和磨除后个性化RPD义齿数据对需要复制的基托部分进行设计与制作；S5. Repeat step S3 to obtain the personalized RPD denture data after grinding. Use the personalized RPD denture data and the personalized RPD denture data after grinding to design and produce the base part that needs to be copied;
S6、导入切片软件进行支撑添加及打印参数设置，导入3D打印机通过光固化成型进行层层打印，打印完成后去除支撑，再进行后固化处理，得到打印基托；S6. Import the slicing software to add supports and set printing parameters. Import the 3D printer to print layer by layer through light curing molding. After the printing is completed, remove the supports and perform post-curing processing to obtain the printing base;
S7、将S6所得打印基托通过定位球凹关系完全就位于磨除后个性化RPD义齿上，粘接、固化、打磨、抛光，完成复制。S7. Place the printed base obtained in S6 completely on the removed personalized RPD denture through the positioning ball concave relationship, bond, solidify, grind and polish to complete the replication.
进一步地，所述制作支架固定的型盒，包括以下步骤：Further, the production of a bracket-fixed mold box includes the following steps:
依据内、外完成线位置用标记笔划定RPD金属支架范围，使用软蜡包埋，藻酸盐包饶，形成支架固定的型盒。Use a marker pen to demarcate the range of the RPD metal bracket based on the position of the inner and outer finishing lines, and use soft wax to embed it and alginate to form a box for the bracket to be fixed.
进一步地，所述磨除的方法为：利用直径1mm的柱状车针沿着定深槽均匀磨除。Further, the grinding method is: using a cylindrical bur with a diameter of 1 mm to grind evenly along the fixed depth groove.
进一步地，所述步骤S6打印完成后采用异丙醇进行清洗。Further, after the printing in step S6 is completed, isopropyl alcohol is used for cleaning.
本申请实施例提供的上述技术方案与现有技术相比至少具有如下优点：The above technical solutions provided by the embodiments of the present application have at least the following advantages compared with the existing technology:
1、本发明公开的一种利用数字化技术进行游离端可摘局部义齿(RPD)个性化基托复制的方法，可以解决临床上游离端可摘局部义齿组织调整剂重衬后个性化基托的复制问题，并在复制过程中保证人工牙与金属支架的不改变；可以解决传统义齿复制流程操作繁杂、耗时耗材，人为因素及材料收缩变形导致的义齿制作精度偏差较大，患者等待周期长等问题；可以减少对传统技艺的经验依赖，降低技术敏感性，为初学者提供便利，形成标准化制作流程；技术推广性较强，相关软件易于操作，方法适用范围较广，可延伸至双侧远中游离端缺失、全口义齿乃至赝复体病例组织调整剂应用后个性化基托的复制。1. The present invention discloses a method for using digital technology to replicate the personalized base of a free-end removable partial denture (RPD), which can solve the clinical problem of personalized bases after relining the free-end removable partial denture tissue adjuster. Copying problems, and ensuring that the artificial teeth and metal brackets remain unchanged during the copying process; it can solve the traditional denture copying process, which is complicated, time-consuming and consumable, and causes large deviations in denture production accuracy caused by human factors and material shrinkage and deformation, and long waiting periods for patients and other problems; it can reduce the reliance on traditional skills experience, reduce technical sensitivity, provide convenience for beginners, and form a standardized production process; the technology is highly popularized, the relevant software is easy to operate, and the method has a wide range of application and can be extended to both sides Replication of personalized bases after application of tissue adjusters in cases of missing distal free ends, complete dentures and even prostheses.
2、本发明的复制方法在简化传统繁杂工艺的同时，保证了人工牙与金属支架的不改变，并通过不同直径的球钻、柱状车针等工具量化控制个性化RPD义齿组织面及边缘磨除深度，通过包埋石膏表面外部标记点的确定及基托组织面定位球凹的设计制作，提高了不同组数据配准的精度及基托装配的精确性，在实现无模装配的同时，提升了临床的修复效果。2. The replication method of the present invention simplifies the traditional complicated process while ensuring that the artificial teeth and metal brackets are not changed, and quantitatively controls the tissue surface and edge grinding of personalized RPD dentures through tools such as ball drills and cylindrical burs of different diameters. In addition to the depth, through the determination of external marking points on the surface of the embedded plaster and the design and production of the positioning spherical concave surface of the base tissue, the accuracy of registration of different sets of data and the accuracy of base assembly are improved. While achieving moldless assembly, Improved clinical repair effect.
附图说明Description of drawings
此处的附图被并入说明书中并构成本说明书的一部分，示出了符合本申请的实施例，并与说明书一起用于解释本申请的原理。The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments consistent with the application and together with the description, serve to explain the principles of the application.
为了更清楚地说明本申请实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，对于本领域普通技术人员而言，在不付出创造性劳动性的前提下，还可以根据这些附图获得其他的附图。In order to more clearly explain the embodiments of the present application or the technical solutions in the prior art, the following will briefly introduce the drawings needed to describe the embodiments or the prior art. Obviously, for those of ordinary skill in the art, It is said that other drawings can be obtained based on these drawings without exerting creative labor.
图1为现有技术中热压注塑技术将需要复制的个性化义齿基托进行围模灌注的示意图；Figure 1 is a schematic diagram of the hot pressing injection molding technology in the prior art for filling the personalized denture base that needs to be copied around the mold;
图2为热压注塑技术将义齿从石膏中完整分离出来的示意图；Figure 2 is a schematic diagram of the hot pressure injection molding technology to completely separate the denture from the plaster;
图3为热压注塑技术复制义齿牙列复位与基托成型的示意图；Figure 3 is a schematic diagram of the hot-press injection molding technology to replicate the denture dentition repositioning and base molding;
图4为热压注塑技术复制义齿制作完成的示意图；Figure 4 is a schematic diagram of the completion of replica denture production using hot-press injection molding technology;
图5为现有技术中数字化技术数控分体切削的工艺图；Figure 5 is a process diagram of CNC split cutting using digital technology in the prior art;
图6为数字化技术数控一体化切削的工艺图；Figure 6 is a process diagram of CNC integrated cutting using digital technology;
图7为数字化技术3D打印的工艺图；Figure 7 is a process diagram of 3D printing using digital technology;
图8为实施例中步骤一的制备流程；Figure 8 is the preparation process of step one in the embodiment;
图9为实施例中步骤二的制备流程；Figure 9 is the preparation process of step two in the embodiment;
图10为实施例中步骤三的制备流程；Figure 10 is the preparation process of step three in the embodiment;
图11为实施例中步骤四的制备流程；Figure 11 is the preparation process of step four in the embodiment;
图12为实施例中步骤五的制备流程；Figure 12 is the preparation process of step five in the embodiment;
图13为实施例中步骤六的制备流程；Figure 13 is the preparation process of step six in the embodiment;
图14为实施例中步骤七的制备流程。Figure 14 is the preparation process of step seven in the embodiment.
具体实施方式Detailed ways
为使本申请实施例的目的、技术方案和优点更加清楚，下面将对本申请实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例是本申请的一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有做出创造性劳动的前提下所获得的所有其他实施例，都属于本申请保护的范围。In order to make the purpose, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below. Obviously, the described embodiments are part of the embodiments of the present application, not All examples. Based on the embodiments in this application, all other embodiments obtained by those of ordinary skill in the art without creative efforts fall within the scope of protection of this application.
除非另有特别说明，本申请中用到的各种原材料、试剂、仪器和设备等，均可通过市场购买得到或者可通过现有方法制备得到。Unless otherwise specified, various raw materials, reagents, instruments and equipment used in this application can be purchased in the market or prepared by existing methods.
以下结合实施例对本发明的原理和特征进行描述，所举实例只用于解释本发明，并非用于限定本发明的范围。实施例中未注明具体条件者，按照常规条件或制造商建议的条件进行。所用试剂或仪器未注明生产厂商者，均为可以通过市售购买获得的常规产品。The principles and features of the present invention are described below with reference to examples. The examples are only used to explain the present invention and are not intended to limit the scope of the present invention. If the specific conditions are not specified in the examples, the conditions should be carried out according to the conventional conditions or the conditions recommended by the manufacturer. If the manufacturer of the reagents or instruments used is not indicated, they are all conventional products that can be purchased commercially.
实施例Example
本实施例提供了一种复制游离端可摘局部义齿基托的方法，包括以下步骤：This embodiment provides a method for replicating a free-end removable partial denture base, which includes the following steps:
步骤一：个性化RPD义齿金属支架的包埋与固定Step 1: Embedding and fixing of personalized RPD denture metal bracket
依据内、外完成线位置用标记笔划定RPD金属支架范围，使用软蜡包埋，藻酸盐包饶，形成支架固定的型盒。待印模材料结固后，热水冲去软蜡，将支架复位于型盒的阴模腔内，予以超硬石膏灌注，完成支架的包埋与固定。Use a marker pen to demarcate the range of the RPD metal bracket based on the position of the inner and outer finishing lines, and use soft wax to embed it and alginate to form a box for the bracket to be fixed. After the impression material is solidified, the soft wax is washed away with hot water, the stent is reset in the female mold cavity of the mold box, and superanhydrite is poured into it to complete the embedding and fixation of the stent.
此步骤的目的在于：减少支架金属反射，方便后续光学扫描的同时，通过在石膏表面设计多个外部标记点，保证材料磨除后个性化RPD义齿与个性化RPD义齿匹配的准确性。The purpose of this step is to reduce the metal reflection of the stent, facilitate subsequent optical scanning, and ensure the accuracy of matching between the personalized RPD denture and the personalized RPD denture after the material is removed by designing multiple external marking points on the plaster surface.
如图8所示，图8中标记1-1为个性化RPD义齿金属支架，1-2为个性化RPD义齿基托，1-3为软蜡包埋支架，1-4为藻酸盐型盒，1-5为支架复位于型盒阴模腔内，1-6为超硬石膏完成支架包埋与固定。As shown in Figure 8, the marks 1-1 in Figure 8 are personalized RPD denture metal brackets, 1-2 are personalized RPD denture bases, 1-3 are soft wax embedded brackets, and 1-4 are alginate type. Box, 1-5 are the brackets reset in the female mold cavity of the mold box, 1-6 are super-hard plaster to complete the embedding and fixation of the brackets.
步骤二：石膏表面外部标记点的设计制作Step 2: Design and production of external marking points on the plaster surface
使用直径约3.6mm的球钻，分别于石膏模型颊、舌侧及上表面刻球形凹槽各3个，用做后续磨除后个性化RPD义齿与个性化RPD义齿全局配准的公共部分；使用直径约1mm的柱状车针，分别于石膏模型颊、舌侧表面雕刻不规则波浪线各1条，要求顶点处形态清晰明确，以便作为后续磨除后个性化RPD义齿与个性化RPD义齿手动配准的标志点选择。Use a ball drill with a diameter of approximately 3.6mm to carve 3 spherical grooves each on the buccal, lingual and upper surfaces of the plaster model, which will be used as a common part for the global registration of the personalized RPD denture and the personalized RPD denture after subsequent grinding; Use a cylindrical bur with a diameter of about 1mm to carve one irregular wavy line each on the buccal and lingual surfaces of the plaster model. The shape of the vertex is required to be clear and clear so that it can be used as a personalized RPD denture after subsequent grinding and a personalized RPD denture manual. Marker point selection for registration.
如图9所示，图9中标记2-1为超硬石膏表面球钻刻槽，2-2为个性化RPD义齿咬合面，2-3为标记完成的球形凹槽，2-4为标记完成的不规则波浪线条。As shown in Figure 9, mark 2-1 in Figure 9 is the ball drill-engraved groove on the superanhydrite surface, 2-2 is the occlusal surface of the personalized RPD denture, 2-3 is the marked spherical groove, and 2-4 is the mark. Finished with irregular wavy lines.
步骤三：个性化RPD义齿的数字化扫描Step Three: Digital Scanning of Personalized RPD Dentures
使用口内扫描仪(3Shape Trios 3，美国)360°扫描上述RPD，获取其组织面、磨光面、咬合面及包埋石膏等数据信息，文件以STL格式保存，导入逆向工程设计软件(GeomagicWrap 2021，3D System)，修剪多余面片，应用“网格医生”功能检查和修复相关数据，命名为“个性化RPD义齿”。Use an intraoral scanner (3Shape Trios 3, USA) to scan the above-mentioned RPD 360° to obtain data information such as its tissue surface, polished surface, occlusal surface and embedded plaster. The file is saved in STL format and imported into the reverse engineering design software (GeomagicWrap 2021 , 3D System), trim the excess surfaces, use the "Grid Doctor" function to check and repair relevant data, and name it "Personalized RPD Denture".
如图10所示，图10中标记3-1为个性化RPD义齿光学模型组织面，3-2为个性化RPD义齿光学模型磨光面，3-3为个性化RPD义齿光学模型咬合面，3-4为超硬石膏表面球形凹槽，3-5为超硬石膏表面不规则波浪线条。As shown in Figure 10, the mark 3-1 in Figure 10 is the tissue surface of the personalized RPD denture optical model, 3-2 is the polished surface of the personalized RPD denture optical model, and 3-3 is the occlusal surface of the personalized RPD denture optical model. 3-4 are spherical grooves on the surface of superanhydrite, and 3-5 are irregular wavy lines on the surface of superanhydrite.
步骤四：个性化RPD义齿组织面及边缘磨除Step 4: Personalized RPD denture tissue surface and edge grinding
使用直径约2mm的球钻，分别于需要复制的个性化RPD义齿基托组织面及边缘制作约1.5-2mm深的定深槽，利用直径约1mm的柱状车针将其沿着定深槽均匀磨除。为了保证后续打印基托与磨除后个性化RPD义齿基托装配精度，在磨除后的组织面制作3个直径约1mm，深度约0.5-1mm的定位球凹，利用其与打印基托定位球间嵌合关系，实现无模装配。Use a ball drill with a diameter of about 2mm to make depth grooves of about 1.5-2mm deep on the tissue surface and edge of the personalized RPD denture base that needs to be copied, and use a cylindrical bur with a diameter of about 1mm to evenly cut them along the depth grooves. grind away. In order to ensure the assembly accuracy of the subsequent printed base and the removed personalized RPD denture base, three positioning ball concavities with a diameter of about 1mm and a depth of about 0.5-1mm were made on the removed tissue surface and used to position the printed base. The fitting relationship between balls enables moldless assembly.
如图11所示，其标记4-1为个性化RPD义齿组织面球钻定深，4-2为个性化RPD义齿颊侧边缘球钻定深，4-3为个性化RPD义齿舌侧边缘球钻定深，4-4为柱状车针沿定深槽均匀磨除，4-5为磨除后个性化RPD义齿组织面，4-6为磨除后个性化RPD义齿边缘，4-7为组织面定位球凹。As shown in Figure 11, the mark 4-1 is the ball drill to determine the depth of the tissue surface of the personalized RPD denture, 4-2 is the ball drill to determine the depth of the buccal edge of the personalized RPD denture, and 4-3 is the lingual edge of the personalized RPD denture. The ball drill determines the depth, 4-4 is the cylindrical bur grinding evenly along the depth-determined groove, 4-5 is the tissue surface of the personalized RPD denture after grinding, 4-6 is the edge of the personalized RPD denture after grinding, 4-7 Locate the spherical concavity for the tissue surface.
步骤五：磨除后个性化RPD义齿的数字化扫描Step 5: Digital scanning of personalized RPD dentures after grinding
使用口内扫描仪(3Shape Trios 3，美国)360°扫描磨除后个性化RPD义齿，获取其组织面、磨光面、咬合面及包埋石膏等数据信息，文件以STL格式保存，导入逆向工程设计软件(Geomagic Wrap 2021，3D System)，修剪多余面片，应用“网格医生”功能检查和修复相关数据，命名为“磨除后个性化RPD义齿”。Use an intraoral scanner (3Shape Trios 3, USA) to scan the personalized RPD denture 360° after grinding to obtain data information such as its tissue surface, polished surface, occlusal surface and embedded plaster. The file is saved in STL format and imported for reverse engineering. Design software (Geomagic Wrap 2021, 3D System), trim excess surfaces, use the "Grid Doctor" function to check and repair relevant data, and name it "Personalized RPD Denture after Grinding".
如图12所示，图12中标记5-1为磨除后个性化RPD义齿基托，5-2为组织面定位球凹，5-3为磨除后个性化RPD义齿边缘，5-4为超硬石膏表面球形凹槽，5-5为超硬石膏表面不规则波浪线条。As shown in Figure 12, the mark 5-1 in Figure 12 is the personalized RPD denture base after grinding, 5-2 is the positioning ball concave on the tissue surface, 5-3 is the personalized RPD denture edge after grinding, 5-4 They are spherical grooves on the surface of superanhydrite, and 5-5 are irregular wavy lines on the surface of superanhydrite.
步骤六：打印基托的设计与制作Step 6: Design and production of printing base
将修整完成的“个性化RPD义齿”与“磨除后个性化RPD义齿”STL文件分别导入逆向工程设计软件(Geomagic Wrap 2021，3D System)，以“个性化RPD义齿”为参考模型进行配准(应用“模型管理器-个性化RPD义齿-钉住”功能)，将“个性化RPD义齿”与“磨除后个性化RPD义齿”两组数据同时选中，利用“手动配准”功能，分别选取超硬石膏模型下方颊侧/舌侧不规则波浪线条同一位置5-10个顶点作为参考标志点，完成模型初步配准，然后分别选择超硬石膏模型上方颊、舌侧及上表面的9个球形凹槽，作为两者“全局配准”的公共部分，完成模型的精细配准。The STL files of the completed "Personalized RPD Denture" and "Personalized RPD Denture after Grinding" were imported into the reverse engineering design software (Geomagic Wrap 2021, 3D System) respectively, and the "Personalized RPD Denture" was used as the reference model for registration. (Apply the "Model Manager-Personalized RPD Denture-Pinning" function), select the two sets of data "Personalized RPD Denture" and "Personalized RPD Denture after Grinding" at the same time, and use the "Manual Registration" function to respectively Select 5-10 vertices at the same position of the irregular wavy lines on the buccal/lingual side below the superhard plaster model as reference landmark points to complete the initial registration of the model, and then select 9 points on the buccal, lingual and upper surfaces of the superhard plaster model respectively. A spherical groove serves as a common part of the "global registration" of the two to complete the fine registration of the model.
之后，选中两组数据，通过“选择贯通”，沿支架内、外完成线将模型进行分割，使用“有界组件”及“Delete”功能，将石膏包埋部分删除，只余留需复制的基托部分。After that, select two sets of data and use "Select Through" to divide the model along the inner and outer completion lines of the bracket. Use the "Bounded Component" and "Delete" functions to delete the plaster embedded part, leaving only the parts that need to be copied. Base part.
利用“多边形-填充单个孔-内部孔”功能，将边缘填补完整。Use the "Polygon-Fill Single Hole-Internal Hole" function to fill the edges completely.
将经过上述处理的“个性化RPD义齿”命名为“个性化RPD基托”，“磨除后个性化RPD义齿”命名为“磨除后个性化RPD基托”。The "personalized RPD denture" that has undergone the above treatment is named "personalized RPD base", and the "personalized RPD denture after grinding" is named "personalized RPD base after grinding".
将“磨除后个性化RPD基托”进行“多边形-偏移整体”，距离设置为0.1mm(统一，保留网格)，预留装配间隙，并将该文件命名为“磨除后个性化RPD基托-偏移0.1mm”。Perform "Polygon-Offset Overall" on the "Personalized RPD Base after Grinding", set the distance to 0.1mm (unified, retain the grid), reserve an assembly gap, and name the file "Personalized after Grinding" RPD Base - Offset 0.1mm".
同时选中“个性化RPD基托”与“磨除后个性化RPD基托-偏移0.1mm”两个文件，利用“联合-布尔运算-减2”功能(选项一栏勾选“创建边界”、“保留原始对象”及“定向结果”)，应用-确定后，得到后续需打印粘接的基托文件，使用“网格医生”功能，对模型进行检查，将存在问题的面片进行相应处理。Select the two files "Personalized RPD Base" and "Personalized RPD Base after Grinding - Offset 0.1mm" at the same time, and use the "Union-Boolean Operation-Subtract 2" function (check "Create Boundary" in the option column , "Keep original object" and "Orientation result"), apply - After confirmation, get the base file that needs to be printed and bonded later, use the "Grid Doctor" function to check the model, and correct the problematic patches accordingly deal with.
将该文件命名为“打印基托”，导入切片软件(RayWare Software，美国)，进行支撑添加及打印参数设置，生成spr文件，导入3D打印机(Sprintray pro95，美国)，通过光固化成型进行层层打印。Name the file "printing base", import it into slicing software (RayWare Software, United States), add supports and set printing parameters, generate a spr file, import it into a 3D printer (Sprintray pro95, United States), and proceed layer by layer through light curing molding Print.
打印完成之后，异丙醇清洗，去除支撑，完成后固化处理。After the printing is completed, it is cleaned with isopropyl alcohol, the support is removed, and the post-curing process is completed.
如图13所示，图13中标记6-1为用于模型手动配准的标志点，6-2为用于模型精细配准的公共区域，6-3为模型进行分割，仅余留复制基托部分，6-4为将基托边缘填补完整，6-5为个性化RPD基托，6-6为磨除后个性化RPD基托-偏移0.1mm，6-7为定位球凹，6-8为打印基托组织面，6-9为与定位球凹嵌合的定位球，6-10为打印基托实体，6-11为定位球实体。As shown in Figure 13, the mark 6-1 in Figure 13 is the landmark point used for manual registration of the model, 6-2 is the public area used for fine registration of the model, and 6-3 is the segmentation of the model, leaving only the copy For the base part, 6-4 is to completely fill the edge of the base, 6-5 is the personalized RPD base, 6-6 is the personalized RPD base after grinding - offset by 0.1mm, 6-7 is the positioning ball concave , 6-8 is the printing base tissue surface, 6-9 is the positioning ball that is concavely fitted with the positioning ball, 6-10 is the printing base entity, and 6-11 is the positioning ball entity.
步骤七：磨除后个性化RPD义齿与打印基托粘接Step 7: After grinding, the personalized RPD denture is bonded to the printed base.
将打印基托通过定位球凹关系完全就位于磨除后个性化RPD义齿上，通过树脂将二者粘接牢固，光照、打磨、抛光，完成义齿复制。The printed base is completely positioned on the personalized RPD denture after grinding through the positioning ball concave relationship. The two are firmly bonded through resin, and then illuminated, ground, and polished to complete the denture replication.
如图14所示，图14中标记7-1为磨除后个性化RPD义齿，7-2为打印基托，7-3为复制义齿组织面，7-4为复制义齿咬合面，7-5为复制义齿颊侧边缘，7-6为复制义齿舌侧边缘。As shown in Figure 14, the mark 7-1 in Figure 14 is the personalized RPD denture after grinding, 7-2 is the printed base, 7-3 is the replicated denture tissue surface, 7-4 is the replicated denture occlusal surface, 7- 5 is the buccal edge of the copied denture, and 7-6 is the lingual edge of the copied denture.
本发明的实施例中提供了一种可摘局部义齿基托的复制方法，是一种用于游离端缺失RPD经组织调整剂调整后的个性化基托的数字化复制技术。首先如图8所示，在RPD金属支架周围使用超硬石膏加以包埋与固定，借助石膏完成支架包埋，减少金属反射，以便后续光学扫描；An embodiment of the present invention provides a method for duplicating a removable partial denture base, which is a digital duplication technology for a personalized base that has been adjusted with a tissue adjuster if the free end of the RPD is missing. First, as shown in Figure 8, superhard gypsum is used around the RPD metal bracket to embed and fix it. The bracket is embedded with the help of gypsum to reduce metal reflection for subsequent optical scanning;
如图9所示，石膏表面设计多个外部标记点，保证基托材料磨除后个性化RPD义齿与个性化RPD义齿匹配的准确性；As shown in Figure 9, multiple external marking points are designed on the plaster surface to ensure the accuracy of matching between the personalized RPD denture and the personalized RPD denture after the base material is removed;
如图11所示，在义齿基托复制过程中，保证人工牙与支架位置不发生改变，通过定深球直径量化控制个性化RPD义齿组织面及边缘磨除深度，保证打印基托厚度的同时，使其均匀一致；As shown in Figure 11, during the copying process of the denture base, it is ensured that the positions of the artificial teeth and the brackets do not change. The depth of the personalized RPD denture tissue surface and edge grinding is quantitatively controlled through the depth-setting ball diameter to ensure that the thickness of the base is printed at the same time. , to make it uniform;
在磨除后个性化RPD义齿组织面设计定位球凹，利用定位球凹与材料磨除后义齿组织面定位球间球凹嵌合关系，实现无模装配的同时，提高打印基托与材料磨除后义齿基托的装配精度，最大限度降低复制义齿与个性化RPD义齿的误差；The personalized RPD denture tissue surface is designed with a positioning ball concave after the material is removed, and the fitting relationship between the positioning ball concave and the positioning ball on the denture tissue surface after the material is removed is used to achieve moldless assembly while improving the printing base and material grinding. The assembly accuracy of the denture base after removal can minimize the error between the copied denture and the personalized RPD denture;
如图13所示，通过个性化RPD义齿与磨除后个性化RPD义齿两组数据的获取，对需要复制的基托部分进行设计与制作；As shown in Figure 13, through the acquisition of two sets of data: the personalized RPD denture and the removed personalized RPD denture, the base part that needs to be copied is designed and produced;
如图14所示，三维打印后，粘接抛光，完成基托复制。As shown in Figure 14, after three-dimensional printing, it is bonded and polished to complete the base replication.
综上所述，本发明的复制方法在简化传统繁杂工艺的同时，保证了人工牙与金属支架的不改变，并通过不同直径的球钻、柱状车针等工具量化控制个性化RPD义齿组织面及边缘磨除深度，通过包埋石膏表面外部标记点的各标志点的确定及基托组织面定位球凹的设计制作，提高了不同组数据配准的精度及基托装配的精确性，在实现无模装配的同时，提升了临床的修复效果。In summary, the replication method of the present invention not only simplifies the traditional complicated process, but also ensures that the artificial teeth and metal brackets are not changed, and quantitatively controls the tissue surface of the personalized RPD denture through tools such as ball drills and cylindrical burs of different diameters. and edge grinding depth. Through the determination of the external marking points on the surface of the embedded plaster and the design and production of the positioning spherical concave surface of the base tissue, the accuracy of registration of different sets of data and the accuracy of base assembly were improved. While achieving moldless assembly, it also improves the clinical repair effect.
以上所述仅是本申请的具体实施方式，使本领域技术人员能够理解或实现本申请。对这些实施例的多种修改对本领域的技术人员来说将是显而易见的，本文中所定义的一般原理可以在不脱离本申请的精神或范围的情况下，在其它实施例中实现。因此，本申请将不会被限制于本文所示的这些实施例，而是要符合与本文所申请的原理和新颖特点相一致的最宽的范围。The above descriptions are only specific embodiments of the present application, enabling those skilled in the art to understand or implement the present application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be practiced in other embodiments without departing from the spirit or scope of the application. Thus, the present application is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features claimed herein.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311152811.9ACN117643512A (en) | 2023-09-07 | 2023-09-07 | Method for copying removable partial denture base at free end |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311152811.9ACN117643512A (en) | 2023-09-07 | 2023-09-07 | Method for copying removable partial denture base at free end |
| Publication Number | Publication Date |
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| CN117643512Atrue CN117643512A (en) | 2024-03-05 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202311152811.9APendingCN117643512A (en) | 2023-09-07 | 2023-09-07 | Method for copying removable partial denture base at free end |
| Country | Link |
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| CN (1) | CN117643512A (en) |
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