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교정치료 후 비심미적인 상악 전치부 비율을 가진 환자에서 체계적인 진단 및 치료과정을 통해 심미성이 개선된 보철 수복 증례

Esthetic improvements through systematic diagnosis and treatment procedures in patients with unesthetic maxillary anterior teeth proportion after orthodontic treatment: Case report

  • 이성민 (단국대학교 치과대학 치과보철학교실) ;
  • 최유성 (단국대학교 치과대학 치과보철학교실)
  • Lee, Seong-Min (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 투고 : 2015.06.22
  • 심사 : 2015.07.10
  • 발행 : 2015.07.31

초록

상악 전치부와 같은 심미성이 요구되는 부위의 치료 시에는 건강하고, 주위조직과 조화를 이루며 매력적인 미소선의 형성을 염두에 두어야 한다. 이에 관하여 미소선, 연조직 및 경조직의 형태뿐 아니라 치아의 해부학적 형태와 비율 또한 고려하여야 한다. 상악 측절치의 왜소치(peg lateralis)로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서는 교정치료만으로 심미적 수복이 이루어지기 힘들 수 있다. 이런 경우, 교정치료가 끝난 이후 치아-치은-안면 구도에서의 진단 및 분석을 통한 치은절제술 및 보철적 수복을 통해 치아간의 근/원심, 폭/길이 비율을 개선시켜야 심미적으로 만족할 만한 결과를 얻어낼 수 있다. 또한, 상악 측절치의 왜소치(peg lateralis) 치아 비율 개선을 위한 보철물 제작 시 치질삭제가 적으며 인접치와 유사한 색조가 재현 가능하고 투명도가 높은 도재 라미네이트 비니어(Porcelain laminate veneer, PLV)가 선호되고 있다. 본 증례에서는 두 명의 20세 여자 환자로 교정치료 후 상악 측절치의 왜소치로 인한 치간이개 및 부적절한 치은 형태로 인해 비심미적인 상악 전치부 비율을 가진 환자에서의 체계적인 진단 및 치료과정을 통해 심미성이 개선된 보철 수복 증례를 보고하고자 한다.

The treatment of areas demanding esthetic requirements, such as maxillary anterior teeth, should take into account the achievement of a healthy, harmonious to the surrounding tissue, and an attractive smile line. In this case report, smile line, soft tissue and hard tissue morphology, and the anatomy and proportion of the tooth, must be considered. In patients with unesthetic maxillary anterior ratio due to inadequate gingival contour and diastema caused by peg lateralis, it would be challenging to achieve an esthetic restoration by orthodontic treatment alone. In such case, after orthodontic treatment, dento-gingivo-facial compositional diagnosis and analysis, followed by gingivectomy and prosthodontic restoration is needed to improve the interdental mesial/distal, width/length ratio to achieve a satisfactory esthetic result. In addition, when improving the tooth proportion of peg lateralis by prosthodontic treatment, Porcelain laminate veneer (PLV), which results in less tooth structure loss, reproduction of similar shade to that of the proximal tooth and high transparency, is recommended. This case report demonstrates esthetic improvements by prosthodontic restoration through systematic diagnosis and treatment procedure in patients with unesthetic maxillary anterior proportion after orthodontic treatment due to peg lateralis by means of two female patients aged twenty years old.

키워드

참고문헌

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