Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지

IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT

하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정

  • Kwon, Joung-Hyun (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Son, Heung-Kyu (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University)
  • 권정현 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 손흥규 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실, 구강과학연구소)
  • Published : 2008.02.29
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Abstract

Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

치아 및 치조골은 복합적인 구조이므로 치아의 함입이나 측방 탈구와 같은 치조와의 변위가 있는 다수 치아를 포함한 외상에서 치조골 골절이 동반될 수 있다. 치조골이 골절되면 치주인대 및 치수로의 혈행이 단절되어 치아의 합병증을 유발할 수 있고, 특히 유치열기 외상은 후속 영구치배에 손상을 줄 가능성이 있으므로 장기간의 관찰이 필요하다. 치아 및 치조골 골절의 치료 시에는 환자의 연령과 외상의 위치 및 범위, 유치의 변위 정도 및 방향을 고려해야하며, 골절편을 재위치 시키고 고정하기 위하여 아치바(arch bar), 레진-강선 고정, 교정용 밴드, 아크릴 또는 금속 캡 스플린트(acrylic or metal cap splint), 화이버 스플린트(fiber-splint) 등의 다양한 방법이 고안되었다. 본 증례는 외상으로 인하여 치조골이 골절되어 내원한 1세 11개월 된 환아로서 모형상에서 레진-강선 오픈 캡 스플린트(resin-wire open cap splint)를 제작하여 고정한 후 양호한 치료 결과를 얻었다. 이 방법은 부가적인 기공 과정이 필요하지만, 유치열기에서 사용할 수 있고, 시술시간이 짧아 비협조적인 환아에게 진정요법 없이 적용할 수 있으며, 일반적인 아크릴 캡 스플린트에 비해 부피가 작아 불편감이 적고, 교합을 방해하지 않으며, 접착시 시멘트가 빠져나갈 공간이 있어서 스플린트의 정확한 안착이 가능하다. 또한 비교적 통증이 적으며 침습적이지 않아 출혈이 없으므로 의과적문제가 있는 경우에도 사용할 수 있다.

Keywords

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