Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

An Esthetic Restoration of the Missing Maxillary Anterior Teeth with the Rotational Path RPD: A Case Report

회전삽입로 국소의치를 이용한 심미적 상악 전치부 수복 증례

  • Lee, Ji-Hye (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University) ;
  • Lim, So-Min (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University) ;
  • Jung, Hye-Eun (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University) ;
  • Kim, Dae-Gon (Department of Prosthodontics and Institute of Oral Science, Gangneung-Wonju National University)
  • 이지혜 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 임소민 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 정혜은 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 김대곤 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소)
  • Received : 2011.04.16
  • Accepted : 2011.06.25
  • Published : 2011.06.30
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Abstract

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

상실된 상악 전치부는 고정성 보철물이나 가철성 보철물 또는 임플란트 보철 등 다양한 방법을 통하여 수복할 수 있다. 이 중 적절하게 제작된 회전삽입로 국소의치는 경제적, 해부학적 한계를 가진 환자에서 기능적, 심미적으로 우수한 결과를 보일 수 있다. 회전삽입로 국소의치는 일반적 국소의치의 일직선 삽입로와는 달리 국소의치의 한 쪽 유지장치부가 먼저 장착된 뒤 회전하면서 반대쪽의 유지부가 삽입되어 의치가 안착된다. 이 때 언더컷 속에 위치하는 견고한 부연결장치에서 유지력을 획득하고 회전삽입로와 평행하게 긴 수로형 혹은 구미형(dovetail) 레스트 시트에서 지지 및 파지를 얻으므로 일반적인 가요성 유지암 및 파지암을 생략할 수 있어 심미적으로 우수하고 위생 관리에도 유리하다. 그러나 회전삽입로 국소의치에서 한번 제작된 견고한 유지부는 정교한 조절이 불가능해 상대적으로 기공작업이 어렵고 정밀한 보철물 디자인이 필요하므로 임상적인 성공을 위해서는 회전삽입로 국소의치의 원리에 대한 깊은 이해가 필요하다. 이번 증례보고는 회전삽입로 국소의치를 장착한 후 장기적인 유지관리의 어려움을 겪은 증례를 소개하고 이를 예방할 수 있는 이론적, 기공적 주의사항을 보고하고자 한다.

Keywords

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