DOI QR코드

DOI QR Code

보철물 제작 후 부정확한 발음을 가진 환자에서 체계적인 진단 및 치료과정을 통한 보철 수복 증례

Prosthetic restoration of the patient with inaccurate pronunciation after prosthesis fabrication through systematic diagnosis and treatment procedure: A case report

  • 최유성 (단국대학교 치과대학 치과보철학교실) ;
  • 이성민 (단국대학교 치과대학 치과보철학교실)
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Lee, Seong-Min (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 투고 : 2016.03.16
  • 심사 : 2016.04.19
  • 발행 : 2016.10.31

초록

최근 들어 치아의 심미적 개선을 위해 전치부 심미 보철물을 제작하는 치료를 진행하는 경우가 있는데, 이 때 심미적인 요소에 치중하여 생물학적, 기계적 요소를 간과하기 쉽다. 이로 인해 중립대 공간 및 치열에 변화가 발생하고, 혀와 구순의 위치가 변화하고, 교합 및 전방유도 변화로 인해 부정확한 발음문제가 유발될 수 있어 이에 대한 체계적인 진단 및 치료과정에 대한 고려가 필요하다고 사료된다. 본 증례에서는 10년 전 제작한 고정성 보철물로 인해 부정확한 발음 및 비심미성으로 불편감을 호소하는 환자에서 음향학적 분석, 심미적 분석, 교합, 중립대 라는 4가지 요소를 이용하여 체계적인 진단 및 치료과정을 통하여 보철물을 재수복하였고, 이에 기능적, 심미적 회복을 도모하여 환자와 술자 모두에게 만족스러운 결과를 얻었기에 보고하는 바이다.

Recently, there are cases where anterior esthetic prostheses are fabricated for better esthetics, but biologic, mechanical factors could be overlooked, too focusing on esthetic factor. This leads to changes in neutral zone, dentition, position of tongue and lips, occlusion and anterior guidance causing inaccurate pronunciation. Therefore, consideration of systematic diagnosis and treatment procedure are required. In this case, prosthesis was refabricated through a systematic diagnosis and treatment procedure using four factor (acoustic analysis, esthetic analysis, occlusion, neutral zone) for the patient who complained of inaccurate pronunciation and esthetics of the fixed prosthesis fabricated 10 years ago. Thus, by promoting functional, esthetic recovery, this case report demonstrates satisfying results to both the patient and dentist.

키워드

참고문헌

  1. Palmer JM. Analysis of speech in prosthodontic practice. J Prosthet Dent 1974;31:605-14. https://doi.org/10.1016/0022-3913(74)90115-2
  2. Kent RA, Read C. The acoustic analysis of speech. 2nd ed. Albany: NY; Thomson Learning; 2002, p. 1-60.
  3. Ladefoged P. A course in phonetics. 5th ed. Wadsworth: Cengage learning; 2006. p. 211-36.
  4. Zarb GA, Bolender CL, Eckert SE, Fenton AH, Jacob RF, Mericske-Stern R. Prosthodontic treatment for edentulous patients: complete dentures and implant-supported prostheses. 12th ed. St. Louis: Mosby; 2003. p. 379-88.
  5. Vaz Freitas S, Melo Pestana P, Almeida V, Ferreira A. Integrating voice evaluation: correlation between acoustic and audio-perceptual measures. J Voice 2015;29:390.e1-7. https://doi.org/10.1016/j.jvoice.2014.08.007
  6. Ahn J, Kim G, Kim YH, Hong J. Acoustic analysis of vowel sounds before and after orthognathic surgery. J Craniomaxillofac Surg 2015;43:11-6. https://doi.org/10.1016/j.jcms.2014.10.002
  7. Burris C, Vorperian HK, Fourakis M, Kent RD, Bolt DM. Quantitative and descriptive comparison of four acoustic analysis systems: vowel measurements. J Speech Lang Hear Res 2014;57:26-45. https://doi.org/10.1044/1092-4388(2013/12-0103)
  8. Fradeani M. Evaluation of dentolabial parameters as part of a comprehensive esthetic analysis. Eur J Esthet Dent 2006;1:62-9.
  9. Calamia JR, Levine JB, Lipp M, Cisneros G, Wolff MS. Smile design and treatment planning with the help of a comprehensive esthetic evaluation form. Dent Clin North Am 2011;55:187-209, vii. https://doi.org/10.1016/j.cden.2011.01.012
  10. Mistry S. Principles of smile design-demystified. J Cosmet Dent 2012;28:116-24.
  11. Alpert RL. A method to record optimum anterior guidance for restorative dental treatment. J Prosthet Dent 1996;76:546-9. https://doi.org/10.1016/S0022-3913(96)90016-5
  12. Sabek M, Trevelo A. Alternative procedure for reconstructing anterior guidance using an autopolymerizing resin pattern. J Prosthet Dent 1996;76:550-3. https://doi.org/10.1016/S0022-3913(96)90017-7
  13. Thornton LJ. Anterior guidance: group function/canine guidance. A literature review. J Prosthet Dent 1990;64:479-82. https://doi.org/10.1016/0022-3913(90)90048-H
  14. Gross MD, Cardash HS. Transferring anterior occlusal guidance to the articulator. J Prosthet Dent 1989;61:282-5. https://doi.org/10.1016/0022-3913(89)90128-5
  15. Nemcovsky CE, Gross MD. Transferring provisional restorations to final master casts. J Oral Rehabil. 1994;21:157-63. https://doi.org/10.1111/j.1365-2842.1994.tb01134.x
  16. Porwal A, Sasaki K. Current status of the neutral zone: a literature review. J Prosthet Dent 2013;109:129-34. https://doi.org/10.1016/S0022-3913(13)60030-X
  17. Al-Magaleh WR, Swelem AA, Shohdi SS, Mawsouf NM. Setting up of teeth in the neutral zone and its effect on speech. Saudi Dent J 2012;24:43-8. https://doi.org/10.1016/j.sdentj.2011.11.004
  18. Ikebe K, Okuno I, Nokubi T. Effect of adding impression material to mandibular denture space in Piezography. J Oral Rehabil 2006;33:409-15. https://doi.org/10.1111/j.1365-2842.2005.01582.x

피인용 문헌

  1. 안정적인 교합접촉을 잃은 환자에서의 전방유도를 고려한 치료증례 vol.57, pp.4, 2016, https://doi.org/10.4047/jkap.2019.57.4.467