The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Full mouth rehabilitation of patient with severe dental caries with implant fixed prosthesis fabricated with milling and 3D printing method: A case report

밀링 및 3D 프린팅 방법으로 제작된 임플란트 보철물을 이용한 심한 우식 환자의 완전 구강 회복 증례

  • Kim, Taeyoon (Department of Prosthodontics, School of Dentistry, Kyung Hee University,) ;
  • Lee, Jun-Suk (Department of Prosthodontics, School of Dentistry, Kyung Hee University,) ;
  • Hong, Seoung-Jin (Department of Prosthodontics, School of Dentistry, Kyung Hee University,) ;
  • Kim, Hyeong-Seob (Department of Prosthodontics, School of Dentistry, Kyung Hee University,) ;
  • Kwon, Kung-Rock (Department of Prosthodontics, School of Dentistry, Kyung Hee University,)
  • 김태윤 (경희대학교 치과대학 치과보철학교실) ;
  • 이준석 (경희대학교 치과대학 치과보철학교실) ;
  • 홍성진 (경희대학교 치과대학 치과보철학교실) ;
  • 김형섭 (경희대학교 치과대학 치과보철학교실) ;
  • 권긍록 (경희대학교 치과대학 치과보철학교실)
  • Received : 2019.04.22
  • Accepted : 2019.05.24
  • Published : 2019.07.31
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Abstract

Passive fit of prosthesis is an essential property of implant supported prosthesis for long term success and minimization of complications. And the property is determined mostly by fabrication procedure. There were limitations of extensive implant prosthesis because conventional casting method generate contraction error of long span prosthesis. However, Computer-aided design/Computer-aided manufacturing (CAD/CAM) technology of 3D printing and milling metal framework can overcome those limitations. This case is a full mouth rehabilitation using extensive implant fixed prosthesis. Removable interim prosthesis was made for esthetic, functional evaluation and a guide for implant insertion. After the insertion, implant fixed interim prosthesis was delivered. After additional evaluation and adjustment, final prosthesis was designed with CAD, the fabricated with CAM. Milling technique was used for anterior screw type implant superstructure and 3D printing technique was used for the anterior and posterior implant copings. Fit of the final restoration was favorable. The practitioner and patient were both esthetically and functionally satisfied with the final result.

임플란트 지지 보철물의 'passive fit'은 보철물의 장기적인 성공과 합병증의 최소화에 핵심적인 요소이다. 그리고 이 요소는 보철물의 제작과정에 의해 대부분 결정된다. 전통적인 주조 방식은 금속의 수축 변형이 발생하여 광범위한 임플란트 보철물에 적용하는데 제한이 있었다. 그러나 Computer-aided design/Computer-aided manufacture (CAD/CAM) 밀링 방식과 3D 프린팅 방식을 사용하면 이러한 한계점을 극복할 수 있다. 본 증례는 광범위한 임플란트 보철물을 사용한 완전 구강 회복 증례이다. 가철성 임시 보철물을 제작하여 심미와 기증을 평가하고 임플란트 식립을 위한 가이드로 사용하였다. 임플란트 식립 후, 임플란트 고정성 임시 보철물이 장착되었다. 추가적인 평가와 조정 후, 최종 보철물이 CAD를 사용하여 설계되었고, CAM을 사용하여 제작되었다. 전치부 임플란트의 나사 유지형 상부구조물은 밀링되어 제작되었고, 전치부 및 구치부 금속도재관의 금속구조물은 3D 프린팅되어 제작되었다. 보철물은 양호한 적합도를 보였고 술자와 환자 모두 증례의 최종 결과에 심미적, 기능적으로 만족하였다.

Keywords

References

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