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中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 299 -303. doi: 10.3877/cma.j.issn.1674-1366.2019.05.007

所属专题： 文献；

临床研究

CAD/CAM切削技术在可摘局部义齿支架制作中的应用
陶进京1, 黄罡1, 黄丽娟2, 孙方方2,†()   
  1. 1. 南京大学医学院附属口腔医院，南京市口腔医院修复工艺科　210008
    2. 南京大学医学院附属口腔医院，南京市口腔医院修复科　210008
  • 收稿日期:2019-06-06 出版日期:2019-10-01
  • 通信作者: 孙方方

Application of CAD/CAM milling technology in fabrication of removable partial denture framework

Jinjing Tao1, Gang Huang1, Lijuan Huang2, Fangfang Sun2,†()   

  1. 1. Department of Dental Laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
    2. Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2019-06-06 Published:2019-10-01
  • Corresponding author: Fangfang Sun
  • About author:
    Corresponding author: Sun Fangfang, Email:
  • Supported by:
    Nanjing Medical Science and Technique Development Foundation(QRX17175)
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引用本文：

陶进京, 黄罡, 黄丽娟, 孙方方. CAD/CAM切削技术在可摘局部义齿支架制作中的应用[J]. 中华口腔医学研究杂志(电子版), 2019, 13(05): 299-303.

Jinjing Tao, Gang Huang, Lijuan Huang, Fangfang Sun. Application of CAD/CAM milling technology in fabrication of removable partial denture framework[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(05): 299-303.

目的

探讨计算机辅助设计与制作（CAD/CAM）切削技术在可摘局部义齿（RPD）支架制作中的临床应用效果。

方法

选取2017年9月至2018年6月南京市口腔医院修复科就诊的Kennedy Ⅰ类牙列缺损患者共26例，采用随机数字表法分为传统方法组和CAD/CAM组，每组13例。常规制取精细印模，其中CAD/CAM组通过扫描石膏模型获取三维数据，CAD RPD支架形态，CAM切削生成支架树脂铸型，常规包埋铸造完成RPD金属支架。传统方法组以常规方法制作支架蜡型，包埋铸造完成RPD支架。临床试戴，比较两种金属支架就位情况，与口内软硬组织的密合度。采用秩和检验的独立样本Mann-Whitney检验进行统计分析。

结果

传统方法组制作的RPD支架9例就位顺利，4例经少量调磨就位，而CAD/CAM组制作的RPD支架10例顺利就位，3例经少量调磨就位。两组RPD支架均无大量调磨仍无法就位的现象发生，就位情况间差异无统计学意义（U = 78.0，P = 0.5）。2组患者中均有12例支架密合，1例支架存在≤3处不密合部位的现象，密合情况之间差异无统计学意义（U = 84.5，P = 0.760）。

结论

CAD/CAM切削支架蜡型制作的RPD金属支架修复效果可以达到临床要求。

关键词: 计算机辅助设计, 义齿，局部，可摘, CAD/CAM切削技术, RPD支架
Objective

To investigate the clinical application of CAD/CAM milling technology in the fabrication of removable partial denture (RPD) framework.

Methods

A total of 26 patients with Kennedy Ⅰ dentition defect were selected and divided into the conventional group and CAD/CAM group by random number table method, 13 in each. Individual tray and polyvinyl siloxane were used to take impressions. 13 digital casts in CAD/CAM group were obtained by plaster model scanning and the frameworks of RPD were designed by computer-aided design (CAD) . The resin frameworks were milled by computer-aided manufacture (CAM) , and the RPD metal frameworks were completed by conventional embedding and casting. The other 13 RPD frameworks in the conventional group were fabricated with the routine method. To compare the differences of the try-in and fitness between the frameworks made by the two kinds of processing technics, the Mann-Whitney test of independent samples was used.

Results

Nine frameworks in the conventional group were emplaced smoothly, while the other four cases faced a small amount of grinding. In the CAD/CAM group, 10 frameworks were emplaced smoothly, and three cases were emplaced with slight grinding. There was no significant difference of the try-in between the frameworks made by the two methods (U = 78.0, P = 0.50) . 12 frameworks in both groups fitted well, and one framework showed no more than 3 sites with slight gaps. There was no statistically significant difference between the fitness (U = 84.5, P = 0.76) of RPD frameworks prepared using the two methods. There was no significant difference of the try-in and fitness between the frameworks made by the two methods.

Conclusion

RPD framework made with CAD/CAM milling technique could meet clinical requirements.

Key words: Computer-aided design, Denture partial removable, CAD/CAM milling technology, Removable partial denture framework
图4 完成的义齿支架在石膏模型上试戴
图5 金属支架密合度检测选点示意图
表1 两种方法制作的可摘局部义齿支架就位情况及支架密合度情况（例）
组别 就位 支架密合度
顺利 需少量调磨 难以就位 密合 不密合部位≤3处 不密合部位≥3处
传统方法组 9 4 0 12 1 0
CAD/CAM组 10 3 0 12 1 0
U值 ? 78.0 ? ? 84.5 ?
P值 ? 0.50 ? ? 0.76 ?
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