DOI QR코드

DOI QR Code

Clinical performance of esthetic ceramic partial-coverage restorations with supra-gingival margin using minimally invasive tooth preparation method according to the concept of adhesive dentistry

접착치의학 개념에 따른 최소 침습적 치아 삭제법을 적용한 심미적인 치은 연상 변연 도재 부분피개관 수복 증례

  • Hong, Myung-Sik (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Lee, Jong-Hyuk (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Ha, Seung-Ryong (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 홍명식 (단국대학교 치과대학 치과보철학교실) ;
  • 최유성 (단국대학교 치과대학 치과보철학교실) ;
  • 이종혁 (단국대학교 치과대학 치과보철학교실) ;
  • 하승룡 (단국대학교 치과대학 치과보철학교실)
  • Received : 2021.02.15
  • Accepted : 2021.04.19
  • Published : 2021.07.31

Abstract

With the rapid development of aesthetic ceramic materials and resin adhesives, the transition from metal ceramic crown to all-ceramic restoration is being actively carried out. When making porcelain restorations, the advantages can be maximized only when appropriate forms and techniques are used. Recently, an esthetic partial-coverage restoration method with supra-gingival margins was introduced by applying a minimally invasive tooth removal method that preserves enamel as much as possible and enhances adhesion efficiency. Through this, various advantages such as minimization of tooth structure removal and ease of excess cement removal can be obtained. In addition, since this manufacturing method does not require cord packing, it is possible to save time for impression taking and reduce patient discomfort. Furthermore, the margins can be clearly obtained without the intervention of gingival fluid or blood, making it possible to manufacture more accurate restorations. In the following cases of patients with partial tooth defects, esthetic ceramic partial-coverage restorations with supra-gingival margin was applied using minimally invasive tooth preparation method according to the concept of adhesive dentistry. Therefore, unnecessary tooth abutment preparation was prevented and residual tooth structure could be preserved as much as possible. After delivery of the ceramic partial-coverage restorations, favorable outcome was obtained.

심미적인 도재 재료와 레진 시멘트의 비약적인 발전으로 임상에서 금속도재관에서 전부도재관으로의 전환이 활발히 이루어지고 있으며, 도재 수복물 제작 시 그에 적합한 형태와 기술을 이용하여야 그 장점을 최대화할 수 있다. 최근 법랑질을 최대한 보존하고 접착 효율을 높이는 최소 침습적 치아 삭제법을 적용하여 치은 연상 변연을 가진 심미적인 도재 부분피 개관 수복방법이 소개되었는데, 이를 통해 치질 삭제의 최소화, 시멘트 제거의 용이성 등 여러 장점들을 얻을 수 있다고 보고된다. 또한 이 제작법은 치은 압배사의 삽입이 불필요하여 치은 압배사 삽입에 소요되는 시간을 절약할 수 있으며 환자의 불편감도 감소시킬 수 있다. 더 나아가 치은 열구액이나 혈액의 개입 없이 명확하게 변연을 채득할 수 있어 더 정확한 수복물 제작이 가능하다고 보고된다. 본 증례에서는 각각 해당 치아 부위에 부분적인 결함이 있는 환자에서 통상적인 전부피개관이 아닌 접착치의학 개념에 따른 최소 침습적 치아 삭제법을 적용한 치은 연상 변연 도재 부분피개관으로 다양한 제작 방법을 활용하여 수복함으로써 불필요한 치아 삭제를 방지하고 잔존 치질을 최대한 보존할 수 있었다. 치료 후 환자와 술자 모두 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

Keywords

Acknowledgement

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety). (Project Number: NTIS 9991007711, KMDF_PR_20200901_0292).

References

  1. Ruiz JL, Kurtz R. Are full-coverage crowns overutilized? Supragingival partial-coverage designs as a first option. Dent Today 2014;33:122, 124-5.
  2. Ruiz JL. Anterior and posterior partial-coverage indirect restorations using supragingival dentistry techniques. J Mass Dent Soc 2012;61:16-9.
  3. Reitemeier B, Hansel K, Walter MH, Kastner C, Toutenburg H. Effect of posterior crown margin placement on gingival health. J Prosthet Dent 2002; 87:167-72. https://doi.org/10.1067/mpr.2002.121585
  4. Edelhoff D, Sorensen JA. Tooth structure removal associated with various preparation designs for anterior teeth. J Prosthet Dent 2002;87:503-9. https://doi.org/10.1067/mpr.2002.124094
  5. Zollner A, Gaengler P. Pulp reactions to different preparation techniques on teeth exhibiting periodontal disease. J Oral Rehabil 2000;27:93-102. https://doi.org/10.1046/j.1365-2842.2000.00503.x
  6. Gurel G, Sesma N, Calamita MA, Coachman C, Morimoto S. Influence of enamel preservation on failure rates of porcelain laminate veneers. Int J Periodontics Restorative Dent 2013;33:31-9. https://doi.org/10.11607/prd.1488
  7. Wagner J, Hiller KA, Schmalz G. Long-term clinical performance and longevity of gold alloy vs ceramic partial crowns. Clin Oral Investig 2003;7:80-5. https://doi.org/10.1007/s00784-003-0205-8
  8. Veneziani M. Posterior indirect adhesive restorations: updated indications and the Morphology Driven Preparation Technique. Int J Esthet Dent 2017;12:204-30.
  9. Ruiz JL. Supra-gingival minimally invasive dentistry: A healthier approach to esthetic restorations. 1st ed. Hoboken; John Wiley & Sons; 2017. p.132-4.
  10. Magne P, Perroud R, Hodges JS, Belser UC. Clinical performance of novel-design porcelain veneers for the recovery of coronal volume and length. Int J Periodontics Restorative Dent 2000;20:440-57.
  11. Rocca GT, Rizcalla N, Krejci I, Dietschi D. Evidence-based concepts and procedures for bonded inlays and onlays. Part II. Guidelines for cavity preparation and restoration fabrication. Int J Esthet Dent 2015;10:392-413.
  12. Chun YH, Raffelt C, Pfeiffer H, Bizhang M, Saul G, Blunck U, Roulet JF. Restoring strength of incisors with veneers and full ceramic crowns. J Adhes Dent 2010;12:45-54. https://doi.org/10.3290/j.jad.a17533
  13. Smith TM, Olejniczak AJ, Reid DJ, Ferrell RJ, Hublin JJ. Modern human molar enamel thickness and enamel-dentine junction shape. Arch Oral Biol 2006; 51:974-95. https://doi.org/10.1016/j.archoralbio.2006.04.012
  14. Sasse M, Krummel A, Klosa K, Kern M. Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic. Dent Mater 2015;31:907-15. https://doi.org/10.1016/j.dental.2015.04.017
  15. Cardoso MV, de Almeida Neves A, Mine A, Coutinho E, Van Landuyt K, De Munck J, Van Meerbeek B. Current aspects on bonding effectiveness and stability in adhesive dentistry. Aust Dent J 2011;56:31-44. https://doi.org/10.1111/j.1834-7819.2011.01294.x
  16. Bruzi G, Carvalho AO, Giannini M, Maia HP, Magne P. Bonding of CAD/CAM lithium disilicate restorations with regular and flowable composite resin with and without wetting resin. Appl Adhes Sci 2018;6:1-9. https://doi.org/10.1186/s40563-017-0102-z
  17. Atlas A, Grandini S, Martignoni M. Evidence-based treatment planning for the restoration of endodontically treated single teeth: importance of coronal seal, post vs no post, and indirect vs direct restoration. Quintessence Int 2019;50:772-81.
  18. Goujat A, Abouelleil H, Colon P, Jeannin C, Pradelle N, Seux D, Grosgogeat B. Marginal and internal fit of CAD-CAM inlay/onlay restorations: A systematic review of in vitro studies. J Prosthet Dent 2019;121:590-7. https://doi.org/10.1016/j.prosdent.2018.06.006
  19. Lima FF, Neto CF, Rubo JH, Santos GC Jr, Moraes Coelho Santos MJ. Marginal adaptation of CAD-CAM onlays: Influence of preparation design and impression technique. J Prosthet Dent 2018;120:396-402. https://doi.org/10.1016/j.prosdent.2017.10.010
  20. Kois DE, Isvilanonda V, Chaiyabutr Y, Kois JC. Evaluation of fracture resistance and failure risks of posterior partial coverage restorations. J Esthet Restor Dent 2013;25:110-22. https://doi.org/10.1111/jerd.12018
  21. Peumans M, De Munck J, Van Landuyt K, Van Meerbeek B. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Dent Mater 2015;31:308-14. https://doi.org/10.1016/j.dental.2015.01.005
  22. Guess PC, Strub JR, Steinhart N, Wolkewitz M, Stappert CF. All-ceramic partial coverage restorations-midterm results of a 5-year prospective clinical splitmouth study. J Dent 2009;37:627-37. https://doi.org/10.1016/j.jdent.2009.04.006
  23. Kramer N, Frankenberger R. Clinical performance of bonded leucite-reinforced glass ceramic inlays and onlays after eight years. Dent Mater 2005;21:262-71. https://doi.org/10.1016/j.dental.2004.03.009