Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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Regeneration of emergence profile with soft tissue graft and wide computer aided design/computer aided mamufacturing abutments: a clinical report

연조직 이식술과 넓은 computer aided design/computer aided mamufacturing 지대주를 이용한 임플란트 고정성 보철물의 출현윤곽 재현

  • Kim, Min-Kyung (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Lee, Ji-Hun (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Ahn, Seung-Geun (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Kim, Kyung-A (Department of Dentistry, School of Medicine, Eulji University) ;
  • Seo, Jae-Min (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University)
  • 김민경 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 이지훈 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 안승근 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 김경아 (을지대학교 의과대학 치과학교실) ;
  • 서재민 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소)
  • Received : 2015.07.17
  • Accepted : 2015.12.05
  • Published : 2015.12.31
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Abstract

Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

최근 구치부 부분 무치악 환자의 임플란트 보철 수복은 기능적뿐만 아니라 심미적으로도 환자의 만족을 이끌어내야 하는 과제를 안고 있다. 이렇게 환자의 요구가 높아지면서 상실된 자연치아와 유사한 형태의 임플란트 보철을 사용한 구강회복이 보철수복의 중요한 이슈가 되고 있다. 이를 위해서는 기성 지대주 보다는 더 넓은 customized CAD/CAM 지대주를 사용함으로써 자연스러운 출현윤곽을 재현할 수 있다. 넓은 지대주를 지지해주기 위해서는 충분한 폭과 높이를 가지는 각화치은이 존재해야 하는데, 만약 긴 치아상실기간이나 골이식술 등으로 인해 임플란트 주위에 각화치은이 부족한 경우에는 연조직 증대술을 시행하는 것이 추천된다. 이러한 과정을 통해 심미적이고 기능적인 임플란트 보철 제작이 가능하며 구강위생관리를 용이하게 하고 향후 임플란트 주위염의 발생 가능성을 감소시킨다. 본 증례는 구치부 부분 무치악 환자에서 골이식술, 상악동 이식술, 임플란트 식립술 및 연조직 이식술을 사용하여 부족한 치조골과 각화치은 및 협측전정을 회복하였으며, customized CAD/CAM 지대주와 지르코니아 보철물을 이용하여 수복한 증례로 주기적인 내원 및 검사를 통해 기능적, 심미적으로 만족할만한 결과를 얻었기에 이 사례를 보고하고자 한다.

Keywords

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