基于画线锯齿扫描策略的上颌无牙颌数字化印模的临床应用效果分析

摘要/Abstract

摘要：

目的探讨一种新策略“画线引导式锯齿路径扫描法”在上颌无牙颌直接数字化个别托盘制作中的准确度及临床应用效果。方法研究分为口外实验与临床试验。口外实验选取标准无牙颌上颌模型,分为标准组(reference model,RM)、对照组(control model,CM)和新策略实验组(experimental model,EM);临床试验包括常规印模组(conventional impression,CP)、间接数字化印模组(indirect digital impression,IP)和新策略试验性直接数字化印模组(experimental direct digital impression,EP)。新策略组采用画线标记结合锯齿状扫描路径进行扫描,获取数字化初印模数据。通过三维偏差分析比较各组正确度与精密度,并采用视觉模拟量表评估医师对个别托盘的满意度。结果在标准模型中,EM组的正确度显著优于CM组(P<0.05),精密度差异无统计学意义。在临床试验中,EP组的初印模正确度显著优于IP组(P<0.05),其终印模质量与CP组差异无统计学意义。医师满意度评价显示,IP组与EP组在边缘整塑上优于CP组,且EP组的整体满意度最高(P<0.05)。结论画线引导式锯齿路径扫描法可有效提高上颌无牙颌直接数字化初印模的准确度,改善个别托盘的边缘适应性与临床操作满意度,具有良好的临床应用前景,值得推广使用。

关键词: 数字化印模, 无牙颌, 口内扫描, 新扫描策略, 准确度

Abstract:

Objective To investigate the accuracy and clinical efficacy of a novel strategy—zigzag scanning guided by marking lines—in the fabrication of direct digital custom trays for maxillary edentulous jaws. Methods An ex vivo experiment and a clinical trial were carried out. The ex vivo experiment selected a standard maxillary edentulous model and was comprised of a reference model group(RM), a control model group (CM), and an experimental model group(EM). The clinical trial was comprised of a conventional impression group(CP), an indirect digital impression group(IP), and an experimental direct digital impression group(EP). The experimental groups employed marking lines combined with a zigzag scanning path to acquire digital preliminary impression data. Three-dimensional deviation analysis was used to compare trueness and precision among groups, while a visual analog scale assessed clinicians’ satisfaction with the custom trays. Results In the standard model, the EM group demonstrated significantly superior trueness compared to the CM group(P<0.05), with no significant difference in precision. In the clinical trial, the EP group showed significantly better trueness for preliminary impressions than the IP group(P<0.05), with final impression quality comparable to the CP group. Clinician satisfaction evaluations revealed that both the IP and EP groups scored significantly higher than the CP group in border molding, and the EP group received the highest score in overall satisfaction(P<0.05). Conclusion The zigzag scanning guided by marking lines effectively improves the accuracy of direct digital preliminary impressions for maxillary edentulous jaws, enhances border adaptation of custom trays, and increases clinical operational satisfaction, demonstrating promising clinical applicability worthy of widespread adoption.

Key words: digital impression, edentulous jaw, intraoral scanning, new scanning strategy, accuracy

中图分类号:

R783.4

张超, 杨婷, 韩莉, 付浩轩, 毛周洪, 唐婉容. 基于画线锯齿扫描策略的上颌无牙颌数字化印模的临床应用效果分析[J]. 口腔医学, 2026, 46(6): 435-441.

ZHANG Chao, YANG Ting, HAN Li, FU Haoxuan, MAO Zhouhong, TANG Wanrong. Analysis of the clinical application effect of digital impressions for edentulous maxilla based on a line-segmented zigzag scanning strategy[J]. Stomatology, 2026, 46(6): 435-441.

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组别	最小值	最大值	平均值	标准偏差	t	P
CM	21.34	43.07	30.70	6.97	0.11	0.905
EM	20.46	59.28	31.24	12.76	0.11	0.905

组别	最小值	最大值	平均值	标准偏差	t	P
CM	214.57	393.06	272.45	59.84	3.62	0.002^*
EM	136.04	296.07	180.64	51.55	3.62	0.002^*

印模种类	组别	平均值	标准偏差	t	P
初印模	IP1与CP1	393.90	106.26	5.34	0.003^*
	EP1与CP1	158.51	19.65	5.34	0.003^*
终印模	IP2与CP2	224.55	15.35	2.25	0.074
	EP2与CP2	206.97	11.47	2.25	0.074

评价项目	CP组	IP组	EP组	F	P	P1(IP vs. CP)	P2(EP vs. CP)	P3(EP vs. IP)
托盘边缘	7.10±0.36	7.20±0.65	7.50±0.80	1.214	0.319	0.712	0.106	0.051
整体形态	7.55±0.51	7.54±0.53	7.63±0.57	0.064	0.938	0.961	0.701	0.676
稳定性	7.69±0.36	7.68±0.42	7.78±0.27	0.165	0.849	0.941	0.528	0.502
边缘整塑	7.48±0.41	7.61±0.39	7.68±0.43	4.822	0.021^*	0.018^*	0.006^**	0.362
终印模质量	7.32±0.30	7.33±0.21	7.34±0.19	0.018	0.982	0.921	0.863	0.915
托盘整体	7.40±0.32	7.45±0.31	7.50±0.32	5.947	0.010^*	0.045^*	0.003^**	0.036^*