구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제34권1호
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  • Pages.46-55
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  • 2018
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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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심한 치주질환을 가진 환자에서 computer aided flapless surgery와 즉시 부하를 통한 전악 구강 회복 증례

Full mouth rehabilitation of a patient with severe periodontitis using immediate loading after computer aided flapless implant surgery

  • 강성훈 (고려대학교 안암병원 치과 보철학교실) ;
  • 최연조 (고려대학교 안암병원 치과 보철학교실) ;
  • 류재준 (고려대학교 안암병원 치과 보철학교실)
  • Kang, Seong hun (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center) ;
  • Choi, Yeon jo (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center) ;
  • Ryu, Jae jun (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center)
  • 투고 : 2017.12.07
  • 심사 : 2018.02.21
  • 발행 : 2018.03.31
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초록

치조골의 흡수와 치주조직의 염증을 동반한 심한 치주질환 환자에서 임플란트를 통한 구강 회복은 임상적으로 어려움이 있다. 하지만 골 형태에 따른 적절한 임플란트 식립 위치를 선정한다면 불필요한 골 이식이나 연조직 수술을 최소로 할 수 있다. 최근에는 cone beam CT 촬영과 소프트웨어를 이용하여 환자의 해부학적 형태와 보철적인 위치를 고려하여 임플란트 식립 위치를 선정할 수 있게 되었고 3D printing 기술을 통해 제작된 surgical guide를 통해 계획된 위치로 정확한 수술이 가능하게 되었다. 본 증례는 70세 여성 환자로 심한 치주질환으로 인해 전악 치아의 발치가 필요하였으며 임플란트 지지 고정성 보철물로 전악 구강회복을 시행하였다. 수술 시에는 보철적인 위치를 고려한 surgical guide를 이용해 flapless 방식으로 임플란트를 식립하였고 수술 전에 CAD/CAM 방식으로 제작된 임시보철물을 즉시 부하하였다. 이후 맞춤형 지대주와 지르코니아를 이용한 보철물을 제작하였으며, 만족스러운 심미 및 기능 회복을 보였기에 보고하는 바이다.

Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant - supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.

키워드

참고문헌

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