Reconstruction of Disharmonious Upper Anterior Dentition by Implant Supported Fixed Prosthesis

임플란트 지지 고정성 보철물로 상악 전치부를 수복한 증례

  • Oh, Sang-Chun (Department of prosthodontics, Sanbon Dental Hospital, College of dentistry, Wonkwang university) ;
  • Chee, Young-Deok (Department of Oral and Maxillofacial Surgery, Sanbon Dental Hospital, College of dentistry, Wonkwang university)
  • 오상천 (원광대학교 치과대학 보철학교실) ;
  • 지영덕 (원광대학교 구강악안면외과학교실)
  • Received : 2008.04.21
  • Accepted : 2008.06.25
  • Published : 2008.06.30

Abstract

Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.

미디어, 인터넷, 상업용 광고 등 사회의 각 분야에서 미용에 대한 관심이 고조되는 상황에서 오늘날, 치과 보철수복은 단지 저작 기능을 회복시키는 것뿐만이 아니라 특히 심미적 관점에서 웰빙이나 삶의 질 향상에도 크게 기여하고 있다. 35세의 남성 환자로써 1) #11, 23의 금속-도재수복물의 도재 파절 2) 안모 수평기준선에 비해 기울어진 상악전치 절단연 3) 안모 수직기준선인 안모 정중선에 비해 편위된 치열정중선 4) 상악 전치의 대칭성 상실을 주소로 내원하였다. 환자는 임플란트 수복을 포함하여 전통적인 고정성 보철 치료로 안모 개선을 요구하였다. 일반적으로 상악 전치부에서 전통 보철이나 임플란트 보철 시술 목적 중의 하나가 치아구도, 치아-안모구도, 그리고 안모구도에서 치열이 매력적으로 그리고 아름답게 느껴지도록 심미 보철물을 제작해 주는 것이다. 본 증례에는 연조직과 경조직의 증대술과 성형술을 바탕으로 교정과, 구강악안면외과, 그리고 보철과가 협진을 통해 자연치와 임플란트를 이용한 금속-도재 수복물로써 기하학적 측면에서 치열의 심미성을 향상시킨 결과를 얻었기에 이를 보고하는 바이다.

Keywords

References

  1. Peck H, Peck S. A concept of facial esthetics. Angle Orthod. 1970; 40: 284-318
  2. Rufenacht CR. Fundamentals of Esthetics., Quintessence Publishing Co, Inc, Chicago, Illinois. 1990
  3. Nyman S, Lindhe J, Karring T et al. The generative potential of the periodontal ligament: An experimental study in the monkey. J Clin Periodontol 9(3): 257-265, 1982 https://doi.org/10.1111/j.1600-051X.1982.tb02065.x
  4. Dahlin c, Sennerby L, Lekholm U, Linde A, Nyman s. Generation of new bone around titanium implants using a membrane technique: An experimental study in rabbits. Int J Oral Maxillofac Implants 4(1): 19-25, 1989
  5. Lazzara R. Immediate implant placement into extraction site: Surgical and restorative advantages. Int J Periodont Rest Dent 9(5): 333-344, 1989
  6. Abrams L. augmentation of the deformed residual edentulous ridge for fixed prosthesis. compend Contin Edu Dent 1: 205-214, 1980
  7. Orth CF. A modification of the connective tissue graft procedure for the treatment of type II and type III ridge deformities. Int J Periodont Rest Dent 16: 267-277, 1996
  8. Gaber DA & Rosenberg ES. The edentulous ridge in fixed prosthodontics. Compend Contin Educ Dent 24: 212-224, 1981
  9. Miller PD. Root coverage using a free soft tissue autograft following citric acid application. Part I. Technique. Int J Periodont Rest Dent 2(2): 65-70, 1982
  10. Holbrook T & Ochsenbein C. Complete coverage of denuded root surfaces with a one-stage gingival graft. Int J Periodont Rest Dent 3(3): 9-27, 1983
  11. Jae-Hoon Jung, Sang-Chun Oh. Perception assessment of esthetics of upper anterior teeth. J Korean Acad Prosthodont 2003;41(5):640-654
  12. Ahmad I. Geometric considerations in anterior dental aesthetics : restorative principles. Pract Periodont Aesthet Dent 1998; 10(7): 813-822
  13. Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod 1999; 21: 517-522 https://doi.org/10.1093/ejo/21.5.517