Journal of the Korean Academy of Esthetic Dentistry (대한심미치과학회지)

Korean Academy of Esthetic Dentistry (대한심미치과학회)
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From TMJ to 3D Digital Smile Design with Virtual Patient Dataset for diagnosis and treatment planning

가상환자 데이터세트를 기반으로 악관절과 심미를 고려한 진단 및 치료계획 수립

  • Received : 2021.10.20
  • Accepted : 2021.11.12
  • Published : 2021.11.21
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Abstract

The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

가상 환자 데이터 세트는 단일 환자로부터 획득한 구강스캔 안면스캔 전신스캔 하악운동경로데이터 등 다양한 소스의 진단 데이터를 하나의 3차원 좌표계로 정렬한 데이터의 집합이다. 치과의사는 가상 환자 데이터 세트를 사용하여 효과적으로 치료 계획을 수립하고 다양한 치료 계획을 가상공간상에서 시뮬레이션 할 수 있으며, 가상 환자 데이터 세트에서 환자의 미소를 디자인 후 그 결과를 시뮬레이션하고 최적의 치료결과를 선택할 수 있다. 가상공간에서 선택된 치료 계획은 3D 프린팅, 밀링, 사출 성형과 같은 제조 기술을 사용하여 환자에게 동일하게 전달될 수 있다. 이러 치료 계획의 전달은 임시 수복물 제작 및 환자의 구강 내에서 목업 확인을 통해 최종 보철물 제작으로 연결할 수 있다. 이와 같이 진단 데이터, 중첩 및 가공의 정확도가 보장된다면 3차원 가상공간 상에서 시뮬레이션된 3D 디지털 스마일 디자인을 실제 환자에게 정확하게 전달할 수 있다. 가상환자데이터세트의 임상적용방법으로 동기능적교합측정 검사를 통해 교합조정치료를 치료계획에서 배제할수 있는 의사결정방법과, 턱관절질환을 가지고 있는 청소년기 특발성 척추측만증 환자의 턱관절 치료전후 전신스캔 비교분석방법, 그리고 전악수복증례인 상하악 총의치환자 진료시 가상환자데이터세트에 기반한 교합평면분석 및 디지털심미분석방법을 제시하였다.

Keywords

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