대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제59권4호
  • /
  • Pages.478-486
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  • 2021
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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진료실 CAD-CAM에 의한 컴퓨터 가이드 임플란트 수술과 즉시 임시보철치료: 증례보고

Computer-guided implant surgery and immediate provisionalization by chair-side CAD-CAM: A case report

  • 현상우 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 이성복 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 이석원 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 조영은 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과)
  • Hyun, Sang Woo (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Lee, sungbok Richard (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Lee, Suk Won (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Cho, Young Eun (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong)
  • 투고 : 2021.06.14
  • 심사 : 2021.08.23
  • 발행 : 2021.10.31
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초록

치과와 기공실을 오가며 복잡하게 진행되는 기존 CAD-CAM 컴퓨터 가이드 제작 방식을 단 순화하기 위하여, 진료실에 설치한 바로가이드 시스템(VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea)을 통하여 Top-Down 개념과 수복 주도개념을 적용하여 1-day 수술과 임시보철을 완료하는 증례를 보고하고자 한다. Pre-Guide를 통해 환자의 중심위에서 교합을 채득하고 CT를 촬영하며, 진료실 내 컴퓨터에서 CAD를 통해 바로가이드를 1시간 내에 제작하였다. 미리 제작된 광중합 레진이 담긴 Pre-Guide 트레이를 술부에 위치시킨 후 중심위에서 CT를 촬영하였다. CT 데이터가 진료실 내 컴퓨터로 전송되면 수복 위치를 정한 후 이어서 3차원적으로 턱뼈에서 임플란트를 식립할 위치를 디자인하여 STL 파일로 추출하였다. 그리고 진료실에 설비된 밀링 기계(VARO-mill)에 Pre-Guide를 고정하여 수술용 가이드를 15분 내에 제작한다. 이 가이드로 환자는 한번 내원하여 임플란트를 계획한 위치에 안전하고 정확하게 수술해 줌과 더불어, 초기고정력이 양호한 임플란트에 대해서는 즉시임시치아까지 장착해 주어 환자에게 즉시 기능이 가능하도록 할 수 있었다.

This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.

키워드

참고문헌

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