基于临床舒适性和力学相容性的超声辅助口腔高速调磨机理及其关键技术

Oral disease, together with cancer and heart disease, is the most common health problem worldwide. Intraoral abrasive finishing techniques play a vital role in the treatment of oral diseases. In restorative dentistry, intraoral abrasive finishing of teeth and ceramic prostheses using dental high-speed handpieces and burs is the key process because the clinical performance of restorations depends on the finishing operation and quality. To improve biomechanical compatibility of all-ceramic restorations and comfortabilty of patients, a novel ultrasonic-assisted intraoral abrasive finishing surgery is proposed. The kinematics of ultrasonic-assisted abrasive finishing process will be approached. Surface and subsurface generation mechanisms in ultrasonic-assisted abrasive finishing of enamel and dental ceramics will be investigated. Ultrasonic vibration, abrasive operational parameters, surface/subsurface generation mechanisms, comfortability of patients, biomechanical compatibility including friction,wear and fatigue of ceramic prostheses will be studied. Interactive relationships between ultrasonic vibration, abrasive operations, surface integrity, clinical comfortability and biomechanical compatibility will be established. A noval approach of ultrasonc-assisted intraoral abrasive finishing will be constructed based on the clinical performance of ceramic restorations. This work will not only provide scientific insights into dental restorations for safe, rapid, accurate and high-quality abrasive finishing of enamel and dental ceramics using high-speed dental handpieces and burs, but also have great significance for developing a new type of ultrasonic-assisted intraoral abrasive finishing technology.

口腔疾病已被列为继癌症和心脑血管疾之后的世界第三大疾病，而口腔高速调磨既是解决口腔疾病的关键技术，也是临床应用频率最高的牙科手术。本项目以提高临床舒适性与力学相容性为目标，提出一种新型超声辅助口腔高速调磨方法。侧重研究超声辅助口腔高速调磨运动学特性，揭示超声辅助高速调磨表面创成机理及其生物力学相容性，建立临床舒适性表征方法和评价准则，揭示超声振动、调磨工艺、修复表面特征、临床舒适性、力学相容性多元关联机制，构建以临床使役性能为驱动的逆向可控超声辅助口腔高速调磨理论与方法，实现口腔高速调磨从"几何精度控制"到"使役性能控制"的跃升。该研究不仅为实现安全、高效、高质的超声辅助口腔高速调磨提供理论依据和科学指导，而且对于打破传统口腔调磨方式，开创一种新型超声辅助口腔调磨技术具有重要意义。

口腔高速调磨是保证牙科陶瓷修复体临床功能质量的关键技术，也是口腔修复临床应用频率最高的手术操作之一。然而，目前传统调磨方法中的高频振动、噪音及切削热-力损伤大等问题，不仅对陶瓷修复体表面/亚表面造成损伤，影响其临床使用性能，而且会伤及修复体周围的软组织、刺激牙髓，给患者造成严重痛苦与损失。本项目以改善临床舒适性、提高调磨效率与陶瓷修复体质量为目标，提出一种新型超声辅助口腔高速调磨方法。建立了径向/切向/轴向三种超声振动辅助高速调磨单颗磨粒运动学方程，并进行运动学仿真分析，揭示出超声振动频率、振动方向、振动幅值等参数对运动轨迹及运动特性的影响规律，从理论层面构建了超声辅助调磨改善机制。设计并建造一维径向/切向/轴向超声及二维超声辅助的牙科高速调磨体外模拟实验平台，可实现有/无超声的自由转换，并可以在超声方向及维数之间方便切换，为超声辅助调磨机理研究提供必备的实验条件。系统研究了超声辅助调磨切削力、表面完整性、车针磨粒磨损等主控物理量的影响规律，揭示超声振动、调磨工艺、修复表面特征、临床舒适性、力学相容性多元关联机制，并在此基础上构建了以提高临床舒适性和修复体质量为导向的超声复合口腔高速调磨方法及其最佳工艺空间。所提出的轴向超声辅助口腔调磨方法，与传统调磨技术相比，可明显降低切向与法向切削力，最大可达30~50%，表面粗糙度与边缘破碎程度可以得到有效改善；同时超声辅助作用可显著改善车针磨粒的脱落及磨屑堆积现象。最后在理论和实验研究基础上，设计一种新型的旋转超声复合牙科手机。上述研究成果，不仅为实现安全、高效、高质的超声辅助口腔高速调磨提供理论依据和科学指导，而且为该超声复合调磨技术实现临床应用提供了器械支持。. 发表/录用SCI/EI检索论文8篇，其中SCI二区论文4篇，三区论文1篇；发表Springer专著1章；参加CIRP、ASME、ISAAT国际权威会议并公开演讲论文3篇；申请/授权中国发明专利5项；培养硕士生3名。