The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
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APPLICATION OF CAD/CAM FOR ORAL REHABILITATION IN A PATIENT WITH DOWN SYNDROME

CAD/CAM을 이용한 다운 증후군 환자의 구강 재건

  • Chung, Hyunjin (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Shim, Joon-Sung (Department of Prosthodontics, College of Dentistry, Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 정현진 (연세대학교 치과대학 소아치과학교실) ;
  • 심준성 (연세대학교 치과대학 치과보철학교실) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실)
  • Received : 2017.06.08
  • Accepted : 2017.06.20
  • Published : 2017.12.30
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Abstract

Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

본 증례는 다운 증후군이 있는 환자의 구강 재건 시 CAD/CAM 시스템 사용의 이점을 모색해보았다. 다운 증후군 환자들의 경우, 보철물 파절의 위험성이 크며 불가피하게 보철물을 재제작할 경우, CAD/CAM 시스템의 기존 데이터를 이용하여 최소한의 기공 과정만 진행하여 보철물을 빠른 시일 내에 재제작할 수 있다. 결과적으로 이는 심미적 및 기능적 개선을 통해 삶의 질을 높일 수 있는 보철물 제작 시 환자의 불편감과 치과의사의 노력을 최소화하는 방법이다.

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References

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