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불안정한 하악운동을 보이는 환자에서 가철성 의치 수복 증례

Full mouth rehabilitation using removable prosthesis of patient with unstable mandible movements: A case report

  • 손동환 (분당서울대학교병원 치과보철과) ;
  • 이양진 (분당서울대학교병원 치과보철과) ;
  • 조득원 (분당서울대학교병원 치과보철과)
  • Sohn, Dong-Hwan (Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Yi, Yang-Jin (Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Jo, Deuk-Won (Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital)
  • 투고 : 2019.09.02
  • 심사 : 2019.10.21
  • 발행 : 2020.01.31

초록

구치부 지지소실과 편측 저작으로 교합이 환자는 불안정한 하악운동을 보이며, 이는 고령의 환자에서 복잡하게 나타날 수 있다. 본 증례에서는 교합붕괴와 이상 하악운동(Oral dyskinesia)을 보이는 환자에서 고딕아치 묘기법(Gothic arch tracing)과 스플릿 캐스트법(Split cast technique)을 이용하여 중심위와 습관적 전방 폐구위를 확인하고자 하였다. 이후 교합안정장치 형태의 임시의치를 사용하여 안정된 교합과 재현성 있는 하악운동을 회복하고자 하였고, 설측교합(Lingualized occlusion) 개념을 이용하여 총의치와 국소의치를 제작해 수복하였다.

Patients with collapsed occlusal support and unilateral chewing show parafunctional mandibular movements, which can be complicated in older patients. Gothic arch tracing and split cast technique are used to confirm the deviation between centric relation and anterior habitual bite in patient who has oral dyskinesia and collapsed occlusion. Temporary denture as occlusal stabilization appliance was provided for stable occlusion and reproducible mandibular movement. Definitive denture was fabricated by lingualized occlusion concept.

키워드

참고문헌

  1. 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
  2. Rivera-Morales WC, Mohl ND. Relationship of occlusal vertical dimension to the health of the masticatory system. J Prosthet Dent 1991;65:547-53. https://doi.org/10.1016/0022-3913(91)90298-B
  3. Blanchet PJ, Rompre PH, Lavigne GJ, Lamarche C. Oral dyskinesia: a clinical overview. Int J Prosthodont 2005;18:10-9.
  4. Viswanath A, Gordon SM. Two cases of oromandibular dystonia referred as temporomandibular joint disorder. Grand Rounds 2012;12:1-5. https://doi.org/10.1102/1470-5206.2012.0001
  5. Dawson PE. Centric relation. Its effect on occluso-muscle harmony. Dent Clin North Am 1979;23:169-80.
  6. Kantor ME, Silverman SI, Garfinkel L. Centric-relation recording techniques-a comparative investigation. J Prosthet Dent 1972;28:593-600. https://doi.org/10.1016/0022-3913(72)90107-2
  7. Wojdyla SM, Wiederhold DM. Using intraoral Gothic arch tracing to balance full dentures and determine centric relation and occlusal vertical dimension. Dent Today 2005;24:74-7.
  8. Parker HM. Effective management of laboratory procedures and use of split-cast technique. J Prosthet Dent 1974;31:325-42.
  9. Scandrett FR, Hanson JG. Technique for attaching the master cast to its split mounting index. J Prosthet Dent 1978;40:467-9. https://doi.org/10.1016/0022-3913(78)90135-X
  10. Michelotti A, Silva R, Paduano S, Cimino R, Farella M. Oromandibular dystonia and hormonal factors: twelve years follow-up of a case report. J Oral Rehabil 2009;36:916-21. https://doi.org/10.1111/j.1365-2842.2009.02007.x
  11. Scott BL. Evaluation and treatment of dystonia. South Med J 2000;93:746-51. https://doi.org/10.1097/00007611-200093080-00001
  12. Balasubramaniam R, Ram S. Orofacial movement disorders. Oral Maxillofac Surg Clin North Am 2008;20:273-85. https://doi.org/10.1016/j.coms.2007.12.010
  13. Goldman JG, Comella CL. Treatment of dystonia. Clin Neuropharmacol 2003;26:102-8. https://doi.org/10.1097/00002826-200303000-00010
  14. Clark GT, Stiles A, Lockerman LZ, Gross SG. A critical review of the use of botulinum toxin in orofacial pain disorders. Dent Clin North Am 2007;51:245-61. https://doi.org/10.1016/j.cden.2006.09.003
  15. Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc 2000;131:211-6. https://doi.org/10.14219/jada.archive.2000.0149
  16. Ryu JW, Yoon CL, Cho YG, Ahn JM. Clinical manifestations in orofacial movement disorders. J Oral Med Pain 2008;33:375-82.
  17. Becker CM, Swoope CC, Guckes AD. Lingualized occlusion for removable prosthodontics. J Prosthet Dent 1977;38:601-8. https://doi.org/10.1016/0022-3913(77)90002-6
  18. Carlsson GE. Symptoms of mandibular dysfunction in complete denture wearers. J Dent 1976;4:265-70. https://doi.org/10.1016/S0300-5712(76)80004-8