以三種指示工具分析口外模型之咬合接觸

實驗目的: 本研究目的在了解咬合箔膜(Bausch arti-foil BK-25, Germany, 8m)、T-Scan(Tekscan Inc., South Boston, MA, USA)、The Dental Prescale System(DPS, Fuji FilmCo., Tokyo, Japan)三種咬合記錄材在相同的體外模型上咬合呈現結果的差異,以及改變咬合接觸時,觀察其咬合呈現,及了解他們與咬合高度、受力大小、與牙周膜模擬與否之間的相關性。材料與方法: 以標準齒模中灌入模擬牙周膜的加成性矽膠模擬自然牙之咬合,固定在咬合器上完成咬合調整至均勻咬合,並以模型掃描機掃描進行數位化建檔(model I),在標準齒模上的上顎左側第一大臼齒的齒位置換預製型支台齒(preformed abutment),同樣模擬牙周膜,注入加成性矽膠模擬自然牙,將支台齒的模型(model II)掃描建檔,製作出齒位 26 的電腦輔助設計/電腦輔助製造(CAD-CAM)純鈦金屬牙冠,設定不同咬合面高度為+40 m、原始高度、-40、-80、-120m 每組各五顆,兩組模型共 50 顆牙冠。以數位化建檔(model III),軟體中比對電腦輔助設計/電腦輔助製造的金屬牙冠咬合面高度(model I & III)。將上下對咬模型以客製化固定器固定於拉力測試機(Instron 5566, Instron Corp., Canton, MA, USA)上,進行 100 牛頓與 200牛頓的垂直受力測試,以模擬口內咬合測量時之受力。測量完自然牙組別後再將支台齒黏著模擬單顆植牙咬合,重複前述步驟進行受力測試。咬合箔膜與 T-scan、DPS 進行觀察分析。以簡單相關與簡單直線回歸分析比較測量之咬點面積、咬力大小在各咬合記錄之中的差異,以及牙冠高度、受力大小、矽膠模擬牙周膜等因素對檢測結果的影響。統計顯著之水準定義為 P<0.05。結論: 1. 咬合箔膜、T-scan、和 DPS 在同樣咬力和測試環境下呈現出的咬合結果有相關性。 2. 牙冠高度增加對測量咬點的結果有影響,包含增加咬點面積、咬點數量,以及測得咬力增加。 3. 牙周膜存在會讓牙冠高度對受力的影響相關性下降,影響測量結果。

關鍵字

咬合箔膜；牙周膜模擬；電腦輔助設計/電腦輔助製造；純鈦金屬牙冠

並列摘要

Research goal: The purpose of this study was to investigate the occlusal contact on the same modelwith three different techniques: articulating foil, T-scan (Tekscan Inc., South Boston, MA, USA), and the Dental Prescale System (DPS, Fuji Film Co., Tokyo, Japan). In addition,the study also explored the relationship between the occlusal contact and other factors, including occlusal height, applied force, and periodontal ligament simulation. Material and Methods: Periodontal ligament simulation was done by adding additional silicone in the standardized typodont model. After mounting on the articulator, occlusal adjustment to even contact was done by articulating foil. Model scanning (model I) was then performed with lab scanner (3Shape D800 lab scanner). Tooth 26 was changed to preformed prepared abutment also with PDL simulation, and then model was scanning was done again (model II) to fabricate CAD-CAM titanium crown on the tooth 26. This study used model I as CAD model, and the metal crowns were fabricated with different levels of occlusal crown height, such as initial height+40m, initial height, -40m, -80m, and - 120m. Each group contained 5 crowns. Two sets of models were established, with 50 crowns in total. The model with metal crown was then also scanned (model III). Model I & model II were imported into the software (Geomagic Control X) and superimposed through best fit algorithm, for analyzing the differences among crown height. Typodont model was fixed on the universal testing machine (Instron 5566, Instron Corp., Canton, MA, USA) via a customized fixator, and vertically loaded as a compression mode to 100N or 200N, simulating the occlusal force intraorally. After testing the nature teeth group, abutment of tooth 26 was cemented with dual-cured resin cement for implant condition simulation. the previous steps of compressive testing were then performed again.Observation of the occlusal of articulating foil, T-scan, DPS was done. Statistical analyseswere performed with descriptive statistics and linear regression, for understanding theinfluence of crown height, applied force, with/without PDL simulation to the results incontact area, contact force and the presented occlusion. (P<0.05) Conclusions: 1. The presented occlusion by articulating foil, T-scan, and DPS under the same occlusal condition had correlation. 2. Increased crown height had an influence on occlusal contact measurement, including increased contact area, amount of contact point, and measured force. 3. The existence of PDL simulation would lessen the influence of crown height to applied force, leading to non-significant results.

並列關鍵字

Articulating foil ； T-scan ； Prescale ； DPS ； PDL simulation ； CAD-CAM titanium metal crown

參考文獻

1. Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale. Clin Oral Implants Res. 2005;16:26-35