Nataly Zambrana^1,*; Stefano Pieralli²; Ilia Fomenko³; Issam Dakir⁴; Silvio Valdec⁵; Newton Sesma¹

¹Prosthodontic Department, University of Sao Paulo, Sao Paulo, Brazil; ²Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center, University of Freiburg, Freiburg, Germany; ³Private practice, Sumy, Ukraine; ⁴Private practice, Beni Mellal, Morocco; ⁵Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland

Background: Long-term success of the dental implant-prosthetic complex is correlated to a biomechanically controlled occlusion. By upgrading from a 3D (static) to a 4D (dynamic) virtual patient reconstruction individual information on the temporomandibular joint (TMJ) and occlusal patterns can be transferred to virtual or analogue articulator systems. However, jaw mobility tracking and analysis systems are currently cost-intensive and not worldwide accessible.

Aim/Hypothesis: This technique presentation describes a novel straightforward method for chairside record and analysis of mandibular kinematic by means of a smartphone and an open-source 3D creation suite.

Material and Methods: Intraoral scans with standard tessellation language (STL) format and a cone beam computed tomography (CBCT) including the TMJ and exported as DICOM (digital imaging and communications in medicine) dataset, are superimposed. Thereafter, visual fiducial markers boards (VFMB) are adapted onto the buccal side of the patient´s teeth and a mobile phone camera with 4K resolution is used to record the mandibular excursions with 60 fps in ambient lighting. A silicone impression of the occlusal bite with integrated VFMB is digitized and aligned to the intraoral scans and CBCT using an add-on module of an open source software. To integrate the mandibular motion a specific algorithm is used to decode the three-dimensional positions of the VFMB and provide a text (txt) file with all 3D coordinates.

Results: Patient-specific parameters as the anterior condylar guide, the Bennett angle, the lateral-excursion angle as well as the maximal mouth opening are reported in millimeters and angles and subsequently transferred to a virtual articulator system. Finally, an individualized dynamic virtual patient model is created and used to analyze both, TMJ function and occlusion patterns.

Conclusion and Clinical implications: Integrating the individual mandibular dynamics to the static virtual patient can be a useful tool for communication, diagnosis and therapy. This technique presents an open-access alternative to the expensive devices available on the market. Rigorous validation process is needed prior to clinical use.

Disclosure of Interest: None Declared

Keywords: biomechanical stability, digital workflow, prosthetic complications

娜塔莉·桑布拉纳^1,* ; 斯特凡诺·皮耶拉利² ; 伊利亚·福缅科³ ; 伊萨姆·达基尔⁴ ; 西尔维奥·瓦尔德克⁵ ; 牛顿塞斯马¹

¹巴西圣保罗圣保罗大学口腔修复系；²修复牙科系，牙科医学中心，医学中心，弗莱堡大学，弗莱堡，德国；³私人执业，苏梅，乌克兰；⁴私人执业，Beni Mellal，摩洛哥；⁵瑞士苏黎世苏黎世大学牙科医学中心颅颌面和口腔外科诊所

背景：牙种植体-修复复合体的长期成功与生物力学控制的咬合相关。通过从 3D（静态）升级到 4D（动态）虚拟患者重建，颞下颌关节 (TMJ) 和咬合模式的个人信息可以传输到虚拟或模拟咬合架系统。然而，颌骨移动性跟踪和分析系统目前成本高昂，并且无法在全球范围内使用。

目标/假设：该技术演示描述了一种新颖的直接方法，用于通过智能手机和开源 3D 创建套件对下颌运动进行椅旁记录和分析。

材料和方法：使用标准曲面细分语言 (STL) 格式和锥形束计算机断层扫描 (CBCT)（包括 TMJ 并导出为 DICOM（医学数字成像和通信）数据集）的口内扫描叠加在一起。此后，将视觉基准标记板 (VFMB) 适配到患者牙齿的颊侧，并使用 4K 分辨率的手机摄像头在环境照明下以 60 fps 记录下颌移动。使用开源软件的附加模块将具有集成 VFMB 的咬合咬合的硅胶印模数字化并与口内扫描和 CBCT 对齐。为了整合下颌运动，使用特定算法解码 VFMB 的 3D 位置并提供包含所有 3D 坐标的文本 (txt) 文件。

结果：患者特定参数如前髁导板、Bennett 角、横向偏移角以及最大张口以毫米和角度报告，随后传输到虚拟咬合架系统。最后，创建个性化动态虚拟患者模型并用于分析 TMJ 功能和咬合模式。

结论和临床意义：将个体下颌动态整合到静态虚拟患者中可以成为交流、诊断和治疗的有用工具。这种技术为市场上可用的昂贵设备提供了一种开放访问的替代方案。在临床使用之前需要严格的验证过程。

利益披露：无申报

关键词：生物力学稳定性，数字化工作流程，假肢并发症