使用不同軟體與電子游標尺比較數位牙科模型和實體模型測量的正確性、可重複性和效率

Accuracy, reproducibility and time efficiency of dental model measurements using software and digital caliper

林汶亭(Wen-Ting Lin)

指導教授 ： 曾于娟

高雄醫學大學/口腔醫學院/牙醫學系碩士班/碩士(2016年)

摘要

研究目的：
本研究之研究目的為研究數位牙科模型之正確性、可重複性和效率。以電子游標尺(digital caliper)測量實體模型當作標準(gold standard)來探討二軟體測量之精準度(accuracy)。比較二軟體由同一研究者測量第一次和第二次，以及比較二軟體由兩位研究者測量是否有不同。
研究方法與材料：
本研究屬於回溯性研究，收集樣本為高雄醫學大學附設醫院齒顎矯正科之病患於矯正治療之前，例行性資料收集的石膏模型共上下顎六十組。納入條件 (Inclusion criteria)包含：(1) 除上下左右之智齒之外沒有缺牙、(2)上下左右除智齒之外皆已經完全萌發、(3)印模清楚且無大氣泡，石膏模型上無缺損或毀壞。本研究採用數位游標尺(digital caliper)測量實體石膏模型當作標準值(gold standard)，並使用二種軟體(Viewbox4和3Shape OrthoAnalyzer)測量數位模型，並探討使用軟體測量數位模型的準確性，與電子游標尺(digital caliper)測量做比較。測量變項包含除智齒之外所有牙齒近遠心寬度、犬齒間寬度、臼齒間寬度、空間差異、Bolton analysis等。

研究結果：
Viewbox4和3Shape OrthoAnalyzer測量所有牙位之近遠心寬度、上下顎犬齒間和臼齒間寬度與電子游標尺(digital caliper)測量比較的平均誤差值皆是小數點下第二位之誤差。使用一般線性模式(General Linear Model)之重複量數(Repeat Measures)分析三種測量方法所得結果，有顯著不同之變項包含：T25、T33、T36、T43、T44、T47、上顎空間需求(Maxillary space require)、下顎空間需求(Mandibular space require)、下顎犬齒間寬度(Mandibular intercanine width)、上顎空間差異(Maxillary space discrepancy)、下顎空間差異(Mandibular space discrepancy)、時間(Time)。其餘變項使用電子游標尺(digital caliper)、Viewbox4和3Shape OrthoAnalyzer之測量無顯著不同。其中使用3Shape OrthoAnalyzer (502.82 ± 51.20秒)測量耗費時間最少，電子游標尺(digital caliper)測量(1002.80 ± 131.172秒)次之，Viewbox4測量(1702.47 ± 360.25秒)則最為耗時。根據擁擠程度分成上顎擁擠組、上顎不擁擠組、下顎擁擠組和下顎部擁擠組，統計分析之結果，得到推論為：齒列的擁擠可能會影響軟體測量的精準度。
結論：
軟體測量應用在例行性矯正治療是臨床上可接受的石膏實體模型測量之替代選擇方案，且誤差皆是臨床上可接受。齒列的擁擠可能會影響軟體測量的精準度。本研究顯示二軟體於同一位施測者測量第一次和第二次以及於第一位施測者和第二位施測者，各項變項均無統計上的不同，具可重複性。其中3Shape OrthoAnalyzer最省時。

關鍵字

數位牙科模型 ； 口內掃描 ； 三維立體 ； 軟體

並列摘要

Objectives:

The objectives of this study were to compare the accuracy, reproducibility, and time efficiency of measurement obtained from digital dental models using two different software. The gold standard was measurement obtained from plaster models using digital caliper. The comparison of the 1st time and 2nd time measurements of the same researcher as well as two different researchers using two different software were also assessed.

Methods:

This study was retrospective study. Sixty maxillary and mandibular plaster models were selected, who received routine data collection prior to orthodontic treatment in Kaohsiung Medical University Hospital (KMUH). The inclusion criteria were : (1)No missing teeth despite maxillary and mandibular wisdom teeth, (2)all teeth were erupted excluding maxillary and mandibular wisdom teeth, (3)the impression must be clear and without huge bubbles, the plaster models should be without any damage or defect. The comparison of the measurement obtained from digital dental models using two different software (Viewbox4 and Shape OrthoAnalyzer) with the gold standard which was obtained from plaster models using digital caliper in order to assess the accuracy of digital dental models. The measurement items include all the teeth mesio-distal width, intercanine width, intermolar width, space discrepancy, and Bolton analysis.

Results

The mean errors of tooth width measurement using Viewbox4 and 3Shape OrthoAnalyzer were smaller than 0.1 mm. All the errors of the measurement were clinically acceptable. The results of General Linear Model analysis showed the measurement items including, T25, T33, T36, T43, T44, T47, Maxillary space require, Mandibular space require, Mandibular intercanine width, Maxillary space discrepancy, Mandibular space discrepancy, Time were statistically significant different. The remaining items were not statistically significant different. 3Shape OrthoAnalyzer (502.82 ± 51.20 seconds) were significantly faster than digital caliper (1002.80 ± 131.172 seconds) and Viewbox4 (1702.47±360.25seconds). The samples was separated as four groups as maxillary crowding group, maxillary non-crowding group, mandibular crowding group and mandibular non-crowding group according to the degree of crowding. After data analysis, we suspected the degree of crowding may affect the accuracy of software measurement.

Conclusions:

The use of digital dental models and software measurements seems to be a clinically acceptable alternative to plaster models for the routine measurements used in orthodontic practice. The degree of crowding may affect the accuracy of software measurement. The result showed reproducibility between the same researcher as well as different researchers using two different software. The 3Shape OrthoAnlyzer was the most time-saving way.

並列關鍵字

digital dental model ； intraoral scanner ； three-dimensional ； software

參考文獻

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