구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제35권4호
  • /
  • Pages.244-252
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  • 2019
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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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상악 전치부 결손 환자의 수술을 동반한 전략적 교정치료 증례

Strategic surgical-combined orthodontic treatment planning of patient with missing incisors on maxilla: a case report

  • 박제혁 (전북대학교 치의학전문대학원 치과교정학교실) ;
  • 전진 (전북대학교 치의학전문대학원 치과교정학교실) ;
  • ;
  • 전영미 (전북대학교 치의학전문대학원 치과교정학교실) ;
  • 김정기 (전북대학교 치의학전문대학원 치과교정학교실)
  • Park, Je-Hyeok (Department of Orthodontics, Institute of Oral Biosciences and School of Dentistry, Chonbuk National University) ;
  • Jeon, Jin (Department of Orthodontics, Institute of Oral Biosciences and School of Dentistry, Chonbuk National University) ;
  • Zhao, Sen (Department of Orthodontics, Institute of Oral Biosciences and School of Dentistry, Chonbuk National University) ;
  • Jeon, Young-Mi (Department of Orthodontics, Institute of Oral Biosciences and School of Dentistry, Chonbuk National University) ;
  • Kim, Jong Ghee (Department of Orthodontics, Institute of Oral Biosciences and School of Dentistry, Chonbuk National University)
  • 투고 : 2019.09.17
  • 심사 : 2019.11.11
  • 발행 : 2019.12.31
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초록

상악 전치의 위치 결정은 수술을 동반한 교정치료의 성공을 위해 꼭 필요한 열쇠이다. 따라서 상악 전치가 전부 소실된 환자에서 수술계획을 수립하는 것은 매우 어려운 일이다. 본 환자는 상악 전치를 외상으로 인해 모두 상실하였으며, 보철 치료를 위한 교정치료를 주소로 내원하였다. 보철 개수를 최소화할 수 있도록 상악의 악궁 형태를 변형하여 4개의 보철 공간을 확립하여 술전교정을 진행하였으며, 3D 가상 보철수복을 참고하여 상악 전치의 위치를 결정하고 하악골 편악수술을 시행하였다. 악교정수술 시 상악골 이식술 및 임플란트 식립이 함께 진행되었으며 비교적 짧은 28개월의 교정치료 기간 후 치료를 마무리하였다. 골격성 III급 환자가 전치 소실 후 치조골이 함께 흡수된 경우 하악궁과의 조화로운 보철수복이 매우 어려우며, 이와 같은 경우에 전략적인 술전교정을 통해 하악골 후방이동수술을 시행하는 것이 더 나은 치료 환경을 제공할 수 있을 것이다.

Proper positioning of maxillary incisors is key to success of surgery combined treatment. Establishing surgery plan would be a difficult job if maxillary incisors are lost. Patient who lost all of her maxillary incisors due to accident came for orthodontic treatment. Through careful modification of maxillary archform, pre-surgical orthodontic treatment was conducted with four prosthetic space consolidation. Position of incisors was decided by help of 3D prosthetic set-up, and 1-jaw surgery was planned. After relative short treatment period of 28 months, final prosthesis was done. When alveolar bone loss happens, harmonious prosthesis of upper incisors is difficult. Utilizing mandibular set-back surgery and incisor positioning using 3D set-up could make a better environment for treatment outcome. Strategic pre-surgical orthodontic treatment can allow shorter time and less number of prosthetics.

키워드

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