【摘要】 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KennedyⅠ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=0.50)。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=0.76)。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。更多还原

【Abstract】 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 smallamount 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.更多还原