The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Management of prosthodontic patients with severe gag reflex using the questionaire and behavior technique: A case report

심한 구역반사를 보이는 환자에서 문진표와 행동 요법을 이용한 임플란트 고정성 보철 수복 증례

  • Sohn, Changmo (Department of Oral and Maxillofacial Surgery, Pusan National Uninversity Dental Hospital) ;
  • Kim, Yu-Jin (Department of Oral and Maxillofacial Surgery, Pusan National Uninversity Dental Hospital) ;
  • Lee, Cheon-Seo (Dental Clinic Center, Pusan National University Hospital) ;
  • Choi, Na-Rae (Dental Clinic Center, Pusan National University Hospital) ;
  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Kim, So-Yeun (Department of Prosthodontics, Kyungpook National University Dental Hospital)
  • 손창모 (부산대학교치과병원 구강악안면외과) ;
  • 김유진 (부산대학교치과병원 구강악안면외과) ;
  • 이천서 (부산대학교병원 치과진료센터) ;
  • 최나래 (부산대학교병원 치과진료센터) ;
  • 권은영 (부산대학교병원 치과진료센터) ;
  • 김소연 (경북대학교치과병원 치과보철과)
  • Received : 2021.02.02
  • Accepted : 2021.05.06
  • Published : 2021.07.31
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Abstract

Although gag reflex is an essential function and a useful physiological defense mechanism, it can become an obstacle in a dental treatment. In this case, a questionnaire was designed and used in consultations to objectify the factors associated with gag reflex. Based on the questionnaire, various treatment protocols were planned, such as behavioral control, which is a systematic desensitization that adapts by placing dental instruments in the oral cavity, and habit control to eliminate vomiting habits after drinking. Except for the placement of the implant fixture under general anesthesia, all restoration procedures were performed in the outpatient clinic in the same manner as the conventional implant fixed prosthetic restoration. The systematic desensitization and behavior technique were repeated until the patient was able to endure discomfort and relieve gag reflex in dental treatment. The patient was successfully received the implant-fixed prosthetic restoration in the partial edentulous region.

구역반사는 필수적인 기능이며 유용한 생리적 방어기전이지만 심한 구역 반사는 보철 치료의 진행을 어렵게 한다. 본 증례는 구역반사를 일으키는 요인을 파악하고 이를 해결하기 하여 문진표와 환자와의 상담을 통해 환자의 구역반사를 일으키는 요인을 객관화하였다. 이에 따른 구강 내 치과용 기구를 위치시킴으로써 적응하는 체계적 탈감작인 행동조절 및 음주 후 구토습관을 없애는 습관조절 등 다양한 해소방안을 계획하였다. 전신마취하 임플란트 고정체 식립을 제외하고 모든 수복 절차는 통상적인 임플란트 고정성 보철 수복과 동일하게 외래에서 진행하였다. 이러한 과정을 통해 구역반사에 의한 불편감이 감소되었고, 환자의 부분 무치악 부위에 임플란트 고정성 보철 수복을 성공적으로 수행하였기에 이를 보고하는 바이다.

Keywords

References

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