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中华口腔医学研究杂志(电子版) ›› 2026, Vol. 20 ›› Issue (01) : 34 -39. doi: 10.3877/cma.j.issn.1674-1366.2026.01.005

数智口腔专栏·综述

功能、美学和微创导向的数字化咬合重建:临床路径与关键技术
张新春(), 王昕, 范乐   
  1. 中山大学附属口腔医院,光华口腔医学院,广东省口腔医学重点实验室,广东省口腔疾病临床医学研究中心,广州 510055
  • 收稿日期:2025-09-02 出版日期:2026-02-01
  • 通信作者: 张新春

Digital occlusal reconstruction guided by functional, aesthetic, and minimally invasive principles: Clinical pathway and key technologies

Xinchun Zhang(), Xin Wang, Le Fan   

  1. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangzhou 510055, China
  • Received:2025-09-02 Published:2026-02-01
  • Corresponding author: Xinchun Zhang
  • Supported by:
    Natural Science Foundation of Guangdong Province(2022A1515012485)
引用本文:

张新春, 王昕, 范乐. 功能、美学和微创导向的数字化咬合重建:临床路径与关键技术[J/OL]. 中华口腔医学研究杂志(电子版), 2026, 20(01): 34-39.

Xinchun Zhang, Xin Wang, Le Fan. Digital occlusal reconstruction guided by functional, aesthetic, and minimally invasive principles: Clinical pathway and key technologies[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2026, 20(01): 34-39.

咬合重建是治疗牙齿严重磨损和牙列缺损等的重要治疗手段。近年来,数字化技术在咬合重建全流程的应用越来越普及,涵盖了从数据采集到咬合分析,从虚拟设计到修复体制作等流程,极大提高了修复的精准度和诊疗效率。本文通过剖析咬合重建中功能、美学与微创原则指导下的临床路径与关键技术,探讨数字化流程的临床价值与当前局限,旨在为咬合重建数字化全流程应用提供临床借鉴和研发策略。

Occlusal reconstruction serves as a critical approach for severe tooth wear and dentition defects. Recently, digital technology has increasingly integrated into the entire workflow of occlusal rehabilitation, covering data acquisition, virtual design and restoration fabrication, which has significantly enhanced both restoration precision and clinical efficiency. Guided by functional, aesthetic, and minimally invasive principles, this paper systematically reviews the clinical pathways and key techniques in occlusal rehabilitation. Furthermore, it explores the clinical value and current limitations of the digital workflow, aiming to provide clinical insights and research strategies for digital occlusal rehabilitation.

图1 不同方式咬合重建临床路径示意图 CBCT:锥形束CT;DSD:数字化微笑设计;CAD/CAM:计算机辅助设计与制作。
图2 数字化咬合重建多模态数据的获取 A:面部扫描;B:口内牙列扫描;C:颌骨锥形束CT(CBCT)重建。
图3 数字化咬合重建虚拟患者的建立(牙列数据+面部扫描+颌骨数据拟合重建) A:正面观;B:左侧面观;C:右侧面观。
图4 数字化咬合重建虚拟架构建及虚拟美学、咬合设计 A:虚拟患者的虚拟架;B:牙列美学设计;C:美学设计完成后的正面观;D:左侧方咬合时面部观;E:前伸咬合时面部观;F:右侧方咬合时面部观;G:左侧方咬合时虚拟牙列+颌骨拟合;H:前伸咬合时虚拟牙列+颌骨拟合;I:右侧方咬合时牙列+颌骨拟合。
图5 数字化三维打印临时修复体 A:上颌微创诊断饰面;B:下颌微创诊断饰面;C:上颌可摘式咬合板;D:下颌可摘式咬合板。
图6 数字化微创咬合重建示例 A:术前照;B:过渡阶段临时修复体;C:过渡修复稳定后咬合记录及电子面弓分析;D:上颌最终全瓷修复体面观(上前牙舌贴面+上后牙贴面+部分冠微创全瓷修复体);E:下颌最终全瓷修复体舌侧观(下前牙贴面+下后牙贴面+部分冠微创全瓷修复体);F:最终修复体正面观;G:戴牙后正面观;H:最终修复后电子面弓记录及分析;I:戴牙后18个月。
图7 咬合重建中的常见微创修复体 A:舌贴面;B:贴面;C:唇贴面;D:部分冠。
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