구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제25권4호
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  • Pages.329-336
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  • 2009
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지

Hemi-Maxillectomy 환자에서 이중온성법을 이용한 폐색장치의 제작

Double Processing Obturator for the Hemi-maxillectomy Treated Patient

  • 홍준원 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 송광엽 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 박미희 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 정수양 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 김경일 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 안승근 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소) ;
  • 박주미 (전북대학교 치의학전문대학원 치과보철학교실, 구강생체과학연구소)
  • Hong, Jun-won (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Song, Kwang-yeob (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Park, Mi-hee (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Jeong, Soo-yang (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Kim, Kyoung-il (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Ahn, Seung-geun (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University) ;
  • Park, Ju-mi (Department of Prosthodontics and Institute for Oral Bio-Science, School of Dentistry, Chonbuk National University)
  • 투고 : 2009.05.12
  • 심사 : 2009.12.25
  • 발행 : 2009.12.31
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초록

선천적 기형이나 후천적인 외상 또는 신생물에 의해 상악골 절제술을 받은 경우, 상악에서 발생하는 구강내 결손은 흔히 비강과 상악동 및 구강이 연결된 형태로 나타난다. 이러한 상악골의 결손은 구강과 비강이 교통되어 발음, 저작, 연하 등의 기능에 이상을 초래하게 된다. 이러한 경우에도 보철치료의 기본적인 목표가 적용되며, 후천적 상악 결손부에 수복되는 폐색장치는 발음, 연하, 저작 기능을 회복할 수 있어야 하고, 적절한 심미적 만족을 제공해야 하며, 환자가 편안하게 사용할 수 있어야 한다. 상악 폐색장치의 무게를 감소시키는 것은 잔존 조직의 건강과 정상적인 기능 및 환자의 안락함을 개선시킬 수 있다. 개방형 폐색장치는 결손부의 크기에 따라 6.55~33.06% 까지 무게를 줄여줌으로써 환자에게 편안함과 편의성을 제공해 주며, 생리적 기능을 향상시켜 치아와 지지 조직에 불필요하게 가해지는 부하를 감소시켜 준다. 본 증례는 hemi-maxillectomy를 시행한 환자에서 이중온성법을 이용하여 기존의 방법보다 더 균일한 의치상 두께를 가진 폐색장치를 제작하여 환자의 기능적, 심미적인 만족을 얻었기에 이를 보고하는 바이다.

In the case of congenital malformation, acquired trauma, or maxillectomy by neoplasm, the defect in maxilla is combined with nasal cavity, maxillary sinus and oral cavity. This results in abnormal function in pronunciation, mastication, and swallowing. In this situation, the purposes of prosthodontics are also applied. The purposes of obturator for acquired maxillary deficiency patients are restoring pronunciation, mastication, and swallowing, and make patients comfortable and esthetic satisfaction. Reducing weight of the obturator makes edentulous ridge heathy and functional. It also improves patients' comfort. Hollow obturator also reduces unnecessary stress because improves physiologic function, as it weights less than 6.55-33.06% compare to usual one. This case presents the double-processing method for maxillary obturator in the patient treated hemi-maxillectomy due to malignancy neoplasm. We report this case because the patient acquired functional and esthetic satisfaction from double-processing obturator.

키워드

참고문헌

  1. Spiro RH, Strong EW, Shah JP. Maxillectomy and its classification. Head and Neck 1997;19:309-314 https://doi.org/10.1002/(SICI)1097-0347(199707)19:4<309::AID-HED9>3.0.CO;2-4
  2. Beumer J, Curtis TA, Marunick MT. Maxillofacial Rehabilitaion Prosthodontic and Surgical Consideration, 2nd edition. St. Louis, MO, Ishiyaku Euroamerica Inc, 1996, p. 225-240
  3. Rieger J, Wolfaardt J, Seikaly H, et al. Speech outcomes in patients rehabilitated with maxillary obturator prostheses after maxillectomy: A prospective study. Int J Prosthodont 2002;15:139-144
  4. Sullivan M, Gaebler C, Beukelman D, et al. Impact of palatal prosthodontic intervention on communication performance of patients' maxillectomy defects: A multilevel outcome study. Head Neck 2002;24:530-538 https://doi.org/10.1002/hed.10095
  5. Umino S, Masuda G, Ono S, et al. Speech intelligibility following maxillectomy with and without a prosthesis: An analysis of 54 cases. J Oral Rehabil 1998;25:153-158 https://doi.org/10.1046/j.1365-2842.1998.00238.x
  6. Brown KE. Peripheral consideration in improving obturator retention. J Prosthet Dent 1968;20:176-181 https://doi.org/10.1016/0022-3913(68)90143-1
  7. Desjardins RP. Obturator prosthesis design for acquired maxillary defects. J Prosthet Dent 1978;39: 424-35 https://doi.org/10.1016/S0022-3913(78)80161-9
  8. Schwartzman B, Caputo AA, Beumer J. Gravity- induced stresses by an obturator prosthesis. J Prosthet Dent 1990;64:466-468 https://doi.org/10.1016/0022-3913(90)90045-E
  9. Minsley GE, Nelson DR, Rothenberger SL. An alternative method for fabrication of a closed hollow obturator. J Prosthet Dent 1986;55:485-490 https://doi.org/10.1016/0022-3913(86)90183-6
  10. Wu YL, Schaaf NG. Comparison of weight reduction in different designs of solid and hollow obturator prostheses. J Prosthet Dent 1989;62:214-217 https://doi.org/10.1016/0022-3913(89)90317-X
  11. Matalon V, LaFuente H. A simplified metohd for making a hollow obturator. J Prosthet Dent 1976;36: 580-582 https://doi.org/10.1016/0022-3913(76)90308-5
  12. Oh W, Roumanas ED. Optimization of maxillary obturator thickness using a double-processing technique. J of prosthodontics 2008;17:60-63
  13. Bruce RW. Complete dentures opposing natural teeth 1971;26:448-455 https://doi.org/10.1016/0022-3913(71)90002-3
  14. Ellinger CW, Rayson JH, Henderson D. Single complete denture J Prosthet Dent 1971;26:4-10 https://doi.org/10.1016/0022-3913(71)90023-0
  15. Nidiffer TJ, Shipmon TH. The hollow bulb obturator for aquired palatal opening. J Prosthet Dent 1957;7:126-134 https://doi.org/10.1016/0022-3913(57)90016-1
  16. El. Mahdy. Processing a hollow obturator. J Prosthet Dent 1969;22:683-686
  17. Bunker H. Construction of a denture with hollow obturator lid and soft acrylic lining. J Prosthet Dent 1969;21:97-103 https://doi.org/10.1016/0022-3913(69)90035-3
  18. Oral K, Aramany MA, Mc Willians BJ. Speech intelligibility with buccal flange obturator. J Prosthet Dent 1979;41:323 https://doi.org/10.1016/0022-3913(79)90017-9
  19. Barry HH, Carl FD. Fabrication of a closed hollow obturator. J Prosthet Dent 2004;91:383-5 https://doi.org/10.1016/j.prosdent.2004.01.020