구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제31권2호
  • /
  • Pages.126-133
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  • 2015
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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비심미적 임플란트의 심미성 회복을 위한 다각적 접근법

Multidisciplinary approach of the problem of unaesthetic implants in the maxillary anterior dentition

  • 주지영 (부산대학교치과병원 치주과) ;
  • 최점일 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 이주연 (부산대학교 치의학전문대학원 치주과학교실)
  • Joo, Ji-Young (Department of Periodontology, Pusan National University Dental Hospital) ;
  • Choi, Jeomil (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Lee, Ju-Youn (Department of Periodontology, School of Dentistry, Pusan National University)
  • 투고 : 2015.03.10
  • 심사 : 2015.05.31
  • 발행 : 2015.06.30
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초록

염증에 의해 파괴된 치주조직은 외과적 방법만으로 조직의 완전한 재생과 심미수복을 이루는 것이 어렵다. 특히, 임플란트와 관련된 문제라면 심미성의 향상을 얻기가 더욱 어렵다. 23세 여자 환자가 비심미적인 전치부 임플란트 보철물을 개선하고자 내원하였다. 개인 치과의원에서 수차례 치조골 이식술과 연조직 이식술을 받았으나 실패한 상태였다. 염증을 제거하고 심미성을 향상시키기 위해 유리치은이식술 시행 후 골유도재생술과 혈관개재 골막결합조직 이식술(vascularized interpositional periosteal connective tissue graft)을 이용한 치조제증대술을 시행하였다. 심미적 보철물 제작을 위해 임플란트 지지형 보철물 대신 인접 자연치를 이용한 전통적인 고정성 보철물을 선택하였다. 상악 전치부 치열에서 비심미적인 임플란트 보철물을 외과적 그리고 보철적 접근을 통한 다각적 방법을 병용함으로써 더 우수한 심미성을 회복한 증례를 소개하고자 한다.

Periodontal tissue destroyed by inflammation is difficult to achieve regeneration of the tissue and esthetic restorations only by surgical methods. In particular, improvement of esthetics is more difficult if the problem is related to the implant. A 23 year old woman suffered from unesthetic anterior implant prosthesis. According to her dental history, a repeated bone graft and soft tissue graft failed at a local dental clinic. It was needed to resolve the inflammation and to improve the esthetics. A free gingival graft and ridge augmentation accompanied by guided bone regeneration and a vascularized interpositional periosteal connective tissue graft was performed. Instead of implant prosthesis, a conventional fixed bridge was adopted for better esthetic result. The patient was satisfied with the esthetic conventional fixed prosthesis. This case report introduces esthetic rehabilitation of unesthetic implant prosthetics in the maxillary anterior dentition by a combination of surgical and prosthetic approaches.

키워드

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