DOI QR코드

DOI QR Code

Reconstruction of upper anterior by implant using customized zirconia abutment and all ceramics: a clinical report

맞춤형 지르코니아 지대주와 완전도재관을 이용한 상악 전치부 임플란트 보철 수복

  • Kim, Ja-Yeong (Department of Dentistry, Presbyterian Medical Center, University of Seonam College of Medicine) ;
  • Seo, Jae-Min (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University)
  • 김자영 (서남대학교 의과대학 예수병원 치과학교실) ;
  • 서재민 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소)
  • Received : 2014.01.04
  • Accepted : 2014.03.09
  • Published : 2014.03.31

Abstract

It is so hard to obtain optimal anterior esthetics in the implant prosthesis. This is not only because of hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also because of prosthetic limitation related to marginal exposure of metal abutment and metal ceramics and low transillumination. In this case, guided soft tissue healing is obtained using a long term provisional restoration with soft and hard tissue augmentation or immediate implantation. Then, this healed tissue is transferred to final master model using a customized impression coping and the implant is restored with a customized zirconia abutment and a all ceramics. This case presents satisfying result esthetically and functionally.

상악 전치부에 임플란트를 이용해 심미적으로 수복 하는 것은 많은 어려움이 따른다. 이는 치조골 흡수와 치간 유두 수축 등과 같은 임플란트 주변 경, 연조직 문제와 금속지대주 및 금속도재관의 변연노출과 낮은 광투과도 등의 보철적 한계 때문이다. 이에 본 증례에서는 경, 연조직의 증대술 및 성형술, 발치 후 즉시 식립 등과 함께 임시수복물의 장기간 사용 및 수정으로 임플란트 주위 연조직의 형태와 건강을 형성한 후, 맞춤형 인상 코핑을 사용하여 이를 최종 모형에 재현하였다. 또한 맞춤형 지르코니아 지대주와 완전 도재관을 이용해 최종 수복함으로써 기능적이고 심미적인 결과를 얻었기에 이를 보고하고자 한다.

Keywords

References

  1. Ericsson I, Berglundh T, Marinello C, Liljenberg B, Lindhe J. Long standing plaque and gingivitis at implant and teeth in the dog. Clin Oral Implant Res 1992;3:99-103. https://doi.org/10.1034/j.1600-0501.1992.030301.x
  2. Hinds KF. Custom impression coping for an exact registration of the healed tissue in the esthetic implnt restoration. Int J Periodontics Restorative Dent 1997;17:584-91.
  3. Calandriello R, Tomatis M, Rangert B. Immediate functional loading of Branemark system implants with enhanced initial stability: a prospective 1- to 2-year clinical and radiographic study. Clin Implant Dent Relat Res 2003;5:10-20. https://doi.org/10.1111/j.1708-8208.2003.tb00011.x
  4. Glauser R, Lundgren AK, Gottlow J, Sennerby L, Portmann M, Ruhstaller P, Hammerle CH. Immediate occlusal loading of Branemark TiUnite implants placed predominantly in soft bone: 1-year results of a prospective clinical study. Clin Implant Dent Relat Res 2003;5:47-56.
  5. Bornstein MM, Hart CN, Halbritter SA, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a chemically modified sand-blasted and acid-etched surface: 6-month results of a prospective case series study in the posterior mandible focusing on peri-implant crestal bone changes and implant stability quotient (ISQ) values. Clin Implant Dent Relat Res 2009;11:338-47. https://doi.org/10.1111/j.1708-8208.2009.00148.x
  6. Rodrigo D, Aracil L, Martin C, Sanz M. Diagnosis of implant stability and its impact on implant survival: a prospective case series study. Clin Oral Implants Res 2010;21:255-61. https://doi.org/10.1111/j.1600-0501.2009.01820.x
  7. Seibert JS, Cohen DW. Periodontal considerations in preparation for fixed and removable prosthodontics. Dent Clin North Am 1987;31:529-55.
  8. Schliephake H, Neukam FW, Scheller H, Bothe KJ. Local ridge augmentation using bone grafts and osseointegrated implants in the rehabilitation of partial edentulism: preliminary results. Int J Oral Maxillofac Implants 1994;9:557-64.
  9. Mayfield L, Nobreus N, Attstrom R, Linde A. Guided bone regeneration in dental implant treatment using a bioabsorbable membrane. Clin Oral Implants Res 1997;8:10-7. https://doi.org/10.1111/j.1600-0501.1997.tb00002.x
  10. Hammerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000 2003;33:36-53. https://doi.org/10.1046/j.0906-6713.2003.03304.x
  11. Jemt T. Customized titanium single-implant abutments: 2-year follow-up pilot study. Int J Prosthodont 1998;11:312-6.
  12. Lang LA, Sierraalta M, Hoffensperger M, Wang RF. Evaluation of the precision of fit between the Procera custom abutment and various implant systems. Int J Oral Maxillofac Implants 2003;18:652-8.
  13. Kim S, Kim HI, Brewer JD, Monaco EA Jr. Comparison of fracture resistance of pressable metal ceramic custom implant abutments with CAD/CAM commercially fabricated zirconia implant abutments. J Prosthet Dent 2009;101:226-30. https://doi.org/10.1016/S0022-3913(09)60043-3
  14. Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Scharer P. Experimental zirconia abutments for implant-suppoted single-tooth restorations in esthetically demanding regions; 4-year results of a prospective clinical study. Int J Prosthodont 2004;17: 285-90.
  15. Yildirim M, Edelhoff D, Hanisch O, Spiekermann H. Ceramic abutments-a new era in achieving optimal esthetics in implant dentistiry. Int J Periodontics Restorative Dent 2000;20:81-91.
  16. Chen ST, Wilson TG Jr, Hammerle CH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants 2004;19:12-25.
  17. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res 2012;23:1-21.