Kois John C, Zeitler Jonathan M, Barmak Abdul B, Yilmaz Burak, Gómez-Polo Miguel, Revilla-León Marta
Founder and Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash.
Director IT, Kois Center, Seattle, Wash.
J Prosthet Dent. 2023 Oct 3. doi: 10.1016/j.prosdent.2023.08.015.
Artificial intelligence (AI) models have been developed for different applications, including the automatic design of occlusal devices; however, the design discrepancies of an experienced dental laboratory technician and these AI automatic programs remain unknown.
The purpose of this in vitro study was to compare the overall, intaglio, and occlusal surface discrepancies of the occlusal device designs completed by an experienced dental laboratory technician and two AI automatic design programs.
Virtually articulated maxillary and mandibular diagnostic casts were obtained in a standard tessellation language (STL) file format. Three groups were created depending on the operator or program used to design the occlusal devices: an experienced dental laboratory technician (control group) and two AI programs, namely Medit Splints from Medit (Medit group) and Automate from 3Shape A/S (3Shape group) (n=10). To minimize the discrepancies in the parameter designs among the groups tested, the same printing material and design parameters were selected. In the control group, the dental laboratory technician imported the articulated scans into a dental design program (DentalCAD) and designed a maxillary occlusal device. The occlusal device designs were exported in STL format. In the Medit and 3Shape groups, the diagnostic casts were imported into the respective AI programs. The AI programs automatically designed the occlusal device without any further operator intervention. The occlusal device designs were exported in STL format. Among the 10 occlusal designs of the control group, a random design (shuffle deck of cards) was used as a reference file to calculate the overall, intaglio, and occlusal discrepancies in the specimens of the AI groups by using a program (Medit Design). The root mean square (RMS) error was calculated. Kruskal-Wallis, and post hoc Dwass-Steel-Critchlow-Fligner pairwise comparison tests were used to analyze the trueness of the data. The Levene test was used to assess the precision data (α=.05).
Significant overall (P<.001), intaglio (P<.001), and occlusal RMS median value (P<.001) discrepancies were found among the groups. Significant overall RMS median discrepancies were observed between the control and the Medit groups (P<.001) and the control and 3Shape groups (P<.001). Additionally, significant intaglio RMS median discrepancies were found between the control and the Medit groups (P<.001), the Medit and 3Shape groups (P<.001), and the control and 3Shape groups (P=.008). Lastly, significant occlusal RMS median discrepancies were found between the control and the 3Shape groups (P<.001) and the Medit and 3Shape groups (P<.001). The AI-based software programs tested were able to automatically design occlusal devices with less than a 100-µm trueness discrepancy compared with the dental laboratory technician. The Levene test revealed significant overall (P<.001), intaglio (P<.001), and occlusal (P<.001) precision among the groups tested.
The use of a dental laboratory technique influenced the overall, intaglio, and occlusal trueness of the occlusal device designs obtained. No differences were observed in the precision of occlusal device designs acquired among the groups tested.
已经开发了用于不同应用的人工智能(AI)模型,包括咬合装置的自动设计;然而,经验丰富的牙科实验室技术人员与这些AI自动程序的设计差异仍然未知。
本体外研究的目的是比较由经验丰富的牙科实验室技术人员和两个AI自动设计程序完成的咬合装置设计在整体、凹面和咬合面的差异。
以标准镶嵌语言(STL)文件格式获取虚拟铰接的上颌和下颌诊断模型。根据用于设计咬合装置的操作员或程序创建三组:一位经验丰富的牙科实验室技术人员(对照组)和两个AI程序,即Medit公司的Medit Splints(Medit组)和3Shape A/S公司的Automate(3Shape组)(n = 10)。为了尽量减少测试组之间参数设计的差异,选择了相同的打印材料和设计参数。在对照组中,牙科实验室技术人员将铰接扫描模型导入牙科设计程序(DentalCAD)并设计上颌咬合装置。咬合装置设计以STL格式导出。在Medit组和3Shape组中,将诊断模型导入各自的AI程序。AI程序在无需操作员进一步干预的情况下自动设计咬合装置。咬合装置设计以STL格式导出。在对照组的10个咬合设计中,使用随机设计(扑克牌洗牌)作为参考文件,通过一个程序(Medit Design)计算AI组样本中的整体、凹面和咬合差异。计算均方根(RMS)误差。使用Kruskal-Wallis检验和事后Dwass-Steel-Critchlow-Fligner成对比较检验来分析数据的准确性。使用Levene检验来评估精确数据(α = 0.05)。
在各组之间发现了显著的整体(P < 0.001)、凹面(P < 0.001)和咬合RMS中值差异(P < 0.001)。在对照组与Medit组(P < 0.001)以及对照组与3Shape组(P < 0.001)之间观察到显著的整体RMS中值差异。此外,在对照组与Medit组(P < 0.001)、Medit组与3Shape组(P < 0.001)以及对照组与3Shape组(P = 0.008)之间发现了显著的凹面RMS中值差异。最后,在对照组与3Shape组(P < 0.001)以及Medit组与3Shape组(P < 0.001)之间发现了显著的咬合RMS中值差异。与牙科实验室技术人员相比,所测试的基于AI的软件程序能够自动设计出真实度差异小于100微米的咬合装置。Levene检验显示在测试组之间存在显著的整体(P < 0.001)、凹面(P < 0.001)和咬合(P < 0.001)精度。
牙科实验室技术的使用影响了所获得的咬合装置设计在整体、凹面和咬合方面的真实度。在测试组之间获得的咬合装置设计精度方面未观察到差异。