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붕괴된 교합을 가진 환자에서 교정치료와 임플란트를 이용한 전악 수복: 증례보고

Full mouth rehabilitation using orthodontic treatment and implants in patient with collapsed occlusion: A case report

  • 안아영 (서울대학교 치의학대학원 치과보철학교실) ;
  • 곽재영 (서울대학교 치의학대학원 치과보철학교실) ;
  • 허성주 (서울대학교 치의학대학원 치과보철학교실) ;
  • 김성균 (서울대학교 치의학대학원 치과보철학교실)
  • Ahn, Ayoung (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Koak, Jai-Young (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Heo, Seong-Joo (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Kim, Seong-Kyun (Department of Prosthodontics, Seoul National University School of Dentistry)
  • 투고 : 2019.06.27
  • 심사 : 2019.09.23
  • 발행 : 2019.10.31

초록

임플란트 식립 시 자연치와 임플란트 사이의 간격은 치주 조직 보존 및 심미에 중요한 요소이다. 또한 고정성 치아 수복 시 치아의 비정상적 위치 이동과 경사 이동은 의도적 근관치료를 필요로 할 수도 있고 저작효율에 불리하게 작용하기도 한다. 본 증례에서는 치열이 불균일하고 붕괴된 교합을 가진 환자에서 완전구강회복을 시행하기에 앞서 치아재배열을 위한 교정치료를 진행하였다. 환자는 통증이나 소리와 같은 측두하악관절장애 증상 및 불편감이 없으므로 교정치료를 진행하는 데 무리가 없었다. 임플란트 식립 전부터 시작한 교정치료를 임플란트 임시 보철물 시적 후에도 진행하였고 전치부 보호 및 심미를 위하여 교합고경을 전치부 기준 2 mm 거상하였다. 교정치료 완료 후 임플란트 및 자연치에 도재전장금관(Porcelain-fused-to-metal crown, PFM crown) 혹은 브릿지(bridge)로 최종 수복하였다. 환자의 치열 개선 및 무치악부 수복으로 기능적, 심미적으로 만족할 만한 결과를 보였다.

The distance between the natural teeth and the implants is an important factor in preserving the periodontal tissues and esthetics. And abnormal positional displacement and tilting of the teeth during restorative procedure may require intentional root canal treatment and may affect masticatory function. This report is to present a successful full mouth rehabilitation of a patient with uneven dentition and collapsed occlusion using orthodontic and implant treatment. The patient had no symptoms or discomfort of temporomandibular joint disorder such as pain or sound. The orthodontic treatment was continued until implant provisional prosthesis delivery. And the vertical height of occlusion was elevated 2mm on anterior basis for anterior teeth protection and esthetics. After the orthodontic treatment, the implant abutments and natural teeth were finally restored with porcelain-fused-to-metal crowns and bridges. Satisfactory function and esthetic outcomes are observed after 6months of follow up.

키워드

참고문헌

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