Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

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

Immediate Connection of Customized Zirconia Abutment Using Flapless Guided Surgery: A Clinical Report

무절개 수술을 이용한 맞춤형 지르코니아 지대주의 즉시 장착 증례

  • Lee, Gyeong-Je (Department of Dentistry, Wonju College of Medicine, Yonsei University) ;
  • Choi, Byung-Ho (Department of Dentistry, Wonju College of Medicine, Yonsei University) ;
  • Kim, Hee-Jun (Department of Dentistry, Wonju College of Medicine, Yonsei University) ;
  • Jung, Seng-Mi (Department of Dentistry, Wonju College of Medicine, Yonsei University)
  • 이경제 (연세대학교 원주의과대학 치과학교실) ;
  • 최병호 (연세대학교 원주의과대학 치과학교실) ;
  • 김희준 (연세대학교 원주의과대학 치과학교실) ;
  • 정승미 (연세대학교 원주의과대학 치과학교실)
  • Received : 2012.04.22
  • Accepted : 2012.06.25
  • Published : 2012.06.30
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Abstract

There are some similar aspects at histological and morphological characteristics between the peri-implant tissue and periodontal tissue and the direct attachment between the titanium and soft tissue around the implant called as "Functional ankylosis" can prevent the apical infiltration of inflammatory and bone resorption around implant. But, the repeated connection and disconnection of the abutment can destroy the mucosal barrier of soft tissue around the implant and can cause the marginal bone resorption. The amount of marginal bone resorption may reduced if the prosthetic abutment is placed at that time of surgery. Connection of the prosthetic abutment at surgery was limited because the low accuracy of conventional method, but by using of Cone Beam Computed Tomography(CBCT) and guide surgery, the 3-dimensional accuracy of implant placement became much higher than before and it became possible. This is a clinical case of immediate connection of prosthetic abutment and provisional restoration by using of precise CBCT diagnosis and pre-fabricated zirconia customized abutment at surgery and the alternative method is described in this article because of the clinically contentable results.

임플란트 주위조직과 치아 주위조직은 조직학, 형태학적으로 유사한 면이 있다. 특히 functional ankylosis라 불리는 티타늄과 연조직의 직접적인 상피부착은 치아주위 조직의 접합상피처럼 염증세포의 치근단으로의 이행 및 그로 인한 골흡수를 막는 역할을 한다. 그러나 반복적인 지대주의 착탈은 임플란트 주위 연조직의 mucosal barrier를 파괴하여 골흡수를 야기할 수 있다. 만일 지대주의 반복적인 착탈 없이 수술 시에 보철 지대주를 채결한다면 골흡수의 양을 줄일 수 있을 것이다. 이는 기존의 수술방법으로는 한계가 있었으나 Cone Beam Computed Tomography(CBCT)를 이용한 guided surgery를 이용함으로써 임플란트 식립의 3차원적 정확성의 비약적인 향상으로 이런 술식이 가능하게 되었다. 본 증례는 정밀한 CBCT를 통한 분석 후 지르코니아 맞춤 지대주를 미리 제작하고 수술 시에 즉시 지대주와 임시보철물을 연결한 경우로 임상적으로 만족할만한 결과를 얻어 이를 보고하는 바이다.

Keywords

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