대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제60권1호
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  • Pages.63-70
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  • 2022
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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치아 상실과 심한 마모를 보이는 골다공증 환자에서의 완전구강 회복 증례

Full mouth rehabilitation in osteoporosis patient with loss of teeth and excessive wear

  • 김현탁 (서울대학교 치의학대학원 치과보철학교실) ;
  • 김명주 (서울대학교 치의학대학원 치과보철학교실) ;
  • 임영준 (서울대학교 치의학대학원 치과보철학교실) ;
  • 권호범 (서울대학교 치의학대학원 치과보철학교실)
  • Kim, Hyun-Tack (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Kim, Myung-Joo (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Lim, Young-Jun (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Kwon, Ho-Beom (Department of Prosthodontics, School of Dentistry, Seoul National University)
  • 투고 : 2021.09.02
  • 심사 : 2021.10.17
  • 발행 : 2022.01.28
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초록

구치부 치아 상실을 동반한 치아 마모는 불규칙한 교합평면, 과도한 전치부 마모와 같은 특징적인 양상을 보인다. 적절한 구치부 지지를 부여하고 조화로운 전방유도와 교합평면을 설정하는 치료 방법이 추천된다. 본 증례 보고의 환자는 치아의 병적인 마모가 관찰되고 하악 구치부 치아가 상실되었다. 또한, 골다공증 병력과 Ibandronate 주사 치료와 관련된 골괴사증의 위험성을 인지하고 수술적 치료를 거부하였다. 본 증례에서는 마모된 잔존치를 수복 공간 확보를 위해 수직 고경 거상을 동반한 완전구강회복술로 수복하고, 하악 무치악부는 양측성 후방연장 국소의치로 수복하였다. 면밀한 진단을 통해 수복 계획을 수립하고, 이를 바탕으로 지대치 형성 후 임시 보철물 상태로 적응 기간을 거쳐 최종 보철물 제작하였다. 심미적, 기능적으로 만족할 만한 결과를 얻을 수 있었고, 구강 위생관리 및 교합 안정성을 확인하기 위해 정기적으로 내원하도록 하였다.

Teeth wear with loss of posterior support often leads to symptoms such as irregular occlusal plane and excessive wear of anterior teeth. In such environment, establishing proper posterior support and harmonious anterior guidance and occlusal plane is recommended. In this case, the patient had excessively worn dentition with loss of posterior support, while denying surgical treatment due to her(his) history of osteoporosis, ibandronate injection, and risk of medication-related osteonecrosis of the jaw (MRONJ). To recover the vertical space needed for prosthetic restoration, full mouth rehabilitation with vertical dimension increase of remaining teeth was decided. Missing teeth in the posterior area were restored with mandibular removable partial denture. The treatment plan was determined through careful diagnosis, and every step of procedures including tooth preparation, provisional phase with the increased vertical dimension, and definitive prosthetic phase were carried out accordingly. Once the treatment was completed, the patient was satisfied functionally and esthetically. Periodic examination of oral hygiene, occlusal stability was conducted.

키워드

참고문헌

  1. Verrett RG. Analyzing the etiology of an extremely worn dentition. J Prosthodont 2001;10:224-33. https://doi.org/10.1111/j.1532-849x.2001.00224.x
  2. 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
  3. Keshvad A, Winstanley RB. An appraisal of the literature on centric relation. Part III. J Oral Rehabil 2001;28:55-63. https://doi.org/10.1046/j.1365-2842.2001.00654.x
  4. American Dental Association Council on Scientific Affairs. Dental management of patients receiving oral bisphosphonate therapy: expert panel recommendations. J Am Dent Assoc 2006;137:1144-50. https://doi.org/10.14219/jada.archive.2006.0355
  5. Mendes V, Dos Santos GO, Calasans-Maia MD, Granjeiro JM, Moraschini V. Impact of bisphosphonate therapy on dental implant outcomes: An overview of systematic review evidence. Int J Oral Maxillofac Surg 2019;48:373-81. https://doi.org/10.1016/j.ijom.2018.09.006
  6. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J 2012;57:2-10. https://doi.org/10.1111/j.1834-7819.2011.01640.x
  7. Turp JC, Greene CS, Strub JR. Dental occlusion: a critical reflection on past, present and future concepts. J Oral Rehabil 2008;35:446-53. https://doi.org/10.1111/j.1365-2842.2007.01820.x
  8. Johansson A, Johansson AK, Omar R, Carlsson GE. Rehabilitation of the worn dentition. J Oral Rehabil 2008;35:548-66. https://doi.org/10.1111/j.1365-2842.2008.01897.x
  9. Abduo J. Safety of increasing vertical dimension of occlusion: a systematic review. Quintessence Int 2012;43:369-80.
  10. Berry DC, Poole DF. Attrition: possible mechanisms of compensation. J Oral Rehabil 1976;3:201-6. https://doi.org/10.1111/j.1365-2842.1976.tb00945.x
  11. 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
  12. Carlsson GE, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth. J Prosthet Dent 1979;41:284-9. https://doi.org/10.1016/0022-3913(79)90008-8
  13. Holzinger D, Seemann R, Matoni N, Ewers R, Millesi W, Wutzl A. Effect of dental implants on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 2014;72:1937.e1-8.
  14. Kim J, Lee DH, Dziak R, Ciancio S. Bisphosphonate-related osteonecrosis of the jaw: Current clinical significance and treatment strategy review. Am J Dent 2020;33:115-28.
  15. Jahangiri L, Jang S. Onlay partial denture technique for assessment of adequate occlusal vertical dimension: a clinical report. J Prosthet Dent 2002;87:1-4. https://doi.org/10.1067/mpr.2002.120845
  16. Sato S, Hotta TH, Pedrazzi V. Removable occlusal overlay splint in the management of tooth wear: a clinical report. J Prosthet Dent 2000;83:392-5. https://doi.org/10.1016/S0022-3913(00)70032-1
  17. Bessadet M, Nicolas E, Sochat M, Hennequin M, Veyrune JL. Impact of removable partial denture prosthesis on chewing efficiency. J Appl Oral Sci 2013;21:392-6. https://doi.org/10.1590/1679-775720130046
  18. Di Fede O, Panzarella V, Mauceri R, Fusco V, Bedogni A, Lo Muzio L, Sipmo Onj Board, Campisi G. The dental management of patients at risk of medication-related osteonecrosis of the jaw: new paradigm of primary prevention. Biomed Res Int 2018;2018:2684924. https://doi.org/10.1155/2018/2684924