口腔医学 ›› 2024, Vol. 44 ›› Issue (12): 917-922.doi: 10.13591/j.cnki.kqyx.2024.12.007

• 基础与临床研究 • 上一篇    下一篇

增减材混合制造无牙颌种植支架的精确性研究

王涵,胡建,李林()   

  1. 南京医科大学附属口腔医院修复科,南京医科大学口腔疾病研究江苏省重点实验室,江苏省口腔转化医学工程研究中心,江苏南京(210029)
  • 收稿日期:2024-01-28 出版日期:2024-12-28 发布日期:2024-12-26
  • 通讯作者: 李 林 E-mail:969965@qq.com
  • 基金资助:
    江苏省科教能力提升工程——江苏省研究型医院(YJXYYJSDW4);江苏省医学创新中心(CXZX202227)

Accuracy of additive and subtractive hybrid fabrication of complete-arch implant titanium frameworks

WANG Han,HU Jian,LI Lin()   

  1. Department of Prosthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
  • Received:2024-01-28 Online:2024-12-28 Published:2024-12-26

摘要:

目的 评估使用减材制造技术和增减材混合制造技术制造的无牙颌钛种植支架的精度差异。方法 运用支架设计软件(EXOCAD)设计具有6颗种植体的上颌无牙颌模型的种植支架,并导出为STL文件。分别使用减材制造技术和增减材混合制造技术各制作5个钛种植支架。使用三坐标测量仪得到每个支架各接口上下平面中心点的三维坐标,并在特定的软件中将其与原始STL文件进行“最佳拟合对齐”,得到每个接口上下平面中心点在xyz轴上的线性偏差和每个接口界面的3D偏差。将中心点坐标导入逆向测量软件(Geomagic Control X)中,通过创建“线特征”计算得到每个接口界面的角度偏差。使用Kruskal-Wallis、ManneWhitney U和单因素方差分析进行统计检验(α=0.05)。结果 在两种制造方法的种植支架接口界面的差异之间,每个接口的xyz轴上的线性偏差和接口界面的3D偏差、角度偏差差异均没有统计学意义(P>0.05),其偏差值均在临床可接受范围内。两种技术中无牙颌种植支架的不同种植位点之间的3D偏差都存在统计学意义。结论 制作技术的差异不会影响种植支架接口界面的准确性。增减材混合制造技术制作的无牙颌固定种植支架的准确性在临床可接受范围内。种植位点对于种植支架精确性存在一定的影响。

关键词: 无牙颌种植, 3D打印, 减材制造, 增材制造, 种植支架

Abstract:

Objective To evaluate the difference in accuracy of edentulous titanium implant frameworks fabricated using subtractive and additive-subtractive hybrid fabrication techniques. Methods Implant frameworks for a maxillary edentulous jaw model with 6 implants were designed using design software(EXOCAD) and exported as STL files. Five titanium implant frameworks were fabricated using subtractive manufacturing(SM) and additive-subtractive hybrid manufacturing(AM-SM) techniques, respectively. The 3D coordinates of the center points of the upper and lower planes of each implant abutment-prosthesis interface were obtained by using a coordinate measuring machine, and were “best-fit-aligned” to the original STL files in a specific software to obtain the linear deviation of the center points of the upper and lower planes of each interface in the x, y, and z axes, and the 3D deviation of each implant abutment-prosthesis interface. The centroid coordinates were imported into a reverse-measurement software(Geomagic Control X) and the angular deviation of each interface was calculated by creating “line features”. Statistical tests were performed using Kruskal-Wallis, ManneWhitney U, and one-way ANOVA(α=0.05). Results Between the differences in the implant abutment-prosthesis interfaces of the two fabrication methods, there was no statistical difference in the linear deviation on the x, y, and z axes of each interface and the 3D deviation and angular deviation of the interface(P>0.05), and the deviation values were within the clinically acceptable range. There were statistically significant differences in the 3D deviation between the different implant sites of the edentulous implant frameworks in both techniques. Conclusion Fabrication techniques do not affect the accuracy of the implant abutment-prosthesis interface. The accuracy of edentulous fixed implant frameworks fabricated by additive-subtractive hybrid fabrication techniques is within the clinically acceptable range. The implant site has a certain influence on the accuracy of the implant framework.

Key words: edentulous implant, 3D printing, subtractive manufacturing, additive manufacturing, implant framework

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