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마모를 동반한 비심미적인 상, 하악 전치부 비율을 가진 환자에서 체계적인 진단 및 치료과정을 통해 기능 및 심미성이 개선된 보철 수복 증례

Functional and esthetic improvement through systematic diagnosis and treatment procedures in patient with unaesthetic anterior teeth proportion because of tooth wear : A case report

  • 정해용 (단국대학교 치과대학 치과보철학교실) ;
  • 최유성 (단국대학교 치과대학 치과보철학교실)
  • Jeong, Hae-Yong (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 투고 : 2017.07.17
  • 심사 : 2017.11.08
  • 발행 : 2018.01.31

초록

상, 하악 전치부 치아의 비심미적인 비율을 갖게 되는 원인은 매우 다양하다고 보고된다. 특히 하악 치조골의 정출을 동반한 전치부 치아의 마모 시, 치은연 상승에 의한 치은 노출 양 증가 및 부적절한 치아 비율로 인해 심각한 기능적, 심미적 문제를 일으킬 수 있다. 이런 경우, 임상적, 방사선학적 방법을 이용한 수직고경 평가와 함께 미소선, 연조직 및 경조직의 형태뿐 아니라 치아의 해부학적 형태와 비율 또한 고려하여야 하는데, 수직고경의 증가 또는 임상적 치관 연장술 및 보철적 수복을 통해 치아간의 근/원심, 폭/길이 비율을 개선시켜야 하며, 이 때 전방 유도를 함께 고려해야 심미적, 기능적으로 만족스러운 치료결과 및 예후를 얻을 수 있다. 본 증례는 48세 남성 환자로서 만성치주염으로 인한 상악 좌, 우측 중절치 및 하악 좌측 중절치의 결손, 하악 전치부 치아의 마모 및 치조골의 정출 등으로 인하여 비심미적인 상, 하악 전치부 비율을 갖고 있었으며, 체계적인 진단 및 치료계획을 통해 기능적, 심미적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

It is reported that the causes of unaesthetic proportion of anterior teeth vary widely. Especially, when the unaesthetic tooth proportion of the mandibular incisors arises due to the wear of the anterior teeth accompanied by the compensation of the alveolar bone, it may cause serious functional and aesthetic problems. In such case, it should be considered that the evaluation of vertical dimension and tooth proportion as well as smile line, soft tissue and hard tissue morphology. And, increase of vertical dimension or clinical crown lengthening followed by prosthodontic restorations is needed to improve the interdental mesial/distal, width/length ratio considering the anterior guidance. This case report demonstrates functional and aesthetic improvements through systematic diagnosis and treatment procedures in a 48-year-old male patient with unaesthetic anterior teeth proportion because of tooth wear accompanied by the compensation of alveolar bone and defect of several central incisors due to chronic periodontitis.

키워드

참고문헌

  1. Johansson A, Johansson AK, Omar R, Carlsson GE. Rehabilitation of the worn dentition. J Oral Rehabil 2008;35:548-66. https://doi.org/10.1111/j.1365-2842.2008.01897.x
  2. Berry DC, Poole DF. Attrition: possible mechanisms of compensation. J Oral Rehabil 1976;3:201-6. https://doi.org/10.1111/j.1365-2842.1976.tb00945.x
  3. Briggs P, Bishop K. Fixed prostheses in the treatment of tooth wear. Eur J Prosthodont Restor Dent 1997;5:175-80.
  4. Hemmings KW, Darbar UR, Vaughan S. Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months. J Prosthet Dent 2000;83:287-93. https://doi.org/10.1016/S0022-3913(00)70130-2
  5. Dawson PE. Functional occlusion from TMJ to smile design. 1st ed. Amsterdam; Elsevier; 2008. p.114-22.
  6. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1984;52:467-74. https://doi.org/10.1016/0022-3913(84)90326-3
  7. Ochsenbein C, Ross S. A reevaluation of osseous surgery. Dent Clin North Am 1969;13:87-102.
  8. Schuyler CH. The function and importance of incisal guidance in oral rehabilitation. 1963. J Prosthet Dent 2001;86:219-32. https://doi.org/10.1067/mpr.2001.118493
  9. Araujo NS, Moda MD, Silva EA, Zavanelli AC, Mazaro JV, Pellizzer EP. Survival of all-ceramic restorations after a minimum follow-up of five years: A systematic review. Quintessence Int 2016;47:395-405.
  10. Ahmad I. Anterior dental aesthetics: facial perspective. Br Dent J 2005;199:15-21.
  11. Dong JK, Jin TH, Cho HW, Oh SC. The esthetics of the smile: a review of some recent studies. Int J Prosthodont 1999;12:9-19.
  12. Monteith B. The role of the free-way space in the generation of muscle pain among denture-wearers. J Oral Rehabil 1984;11:483-98. https://doi.org/10.1111/j.1365-2842.1984.tb00601.x
  13. Orthlieb JD, Laurent M, Laplanche O. Cephalometric estimation of vertical dimension of occlusion. J Oral Rehabil 2000;27:802-7. https://doi.org/10.1046/j.1365-2842.2000.00592.x
  14. Park JH, Jeong CM, Jeon YC, Lim JS. A study on the occlusal plane and the vertical dimension in Korean adults with natural dentition. J Korean Acad Prosthodont 2005;43:41-51.
  15. Willis FM. Features of the face involved in full denture prosthesis. Dent Cosmos 1935;77:851-4.
  16. Mohamed SE, Christensen LV. Mandibular reference positions. J Oral Rehabil 1985;12:355-67. https://doi.org/10.1111/j.1365-2842.1985.tb01290.x
  17. Silverman MM. The speaking method in measuring vertical dimension. 1952. J Prosthet Dent 2001;85:427-31. https://doi.org/10.1067/mpr.2001.116139
  18. Coslet JG, Vanarsdall R, Weisgold A. Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan 1977;70:24-8.

피인용 문헌

  1. 교합면의 교모형태에 따른 치과용 모형 스캐너의 정확도 평가 vol.42, pp.4, 2018, https://doi.org/10.14347/jtd.2020.42.4.313