DOI QR코드

DOI QR Code

Fabrication of complete denture using digital technology in patient with mandibular deviation: a case report

하악 편위 환자에서 디지털 방식을 이용한 총의치 제작 증례

  • Lee, Eunsu (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Juyoung (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Chan (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Yun, Kwi-Dug (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Lim, Hyun-Pil (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Sangwon (Department of Prosthodontics, School of Dentistry, Chonnam National University)
  • 이은수 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박주영 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박찬 (전남대학교 치의학전문대학원 보철학교실) ;
  • 윤귀덕 (전남대학교 치의학전문대학원 보철학교실) ;
  • 임현필 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박상원 (전남대학교 치의학전문대학원 보철학교실)
  • Received : 2022.02.21
  • Accepted : 2022.02.26
  • Published : 2022.03.31

Abstract

Recently, digital technology and computer-aided design/computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of dentures. The denture manufacturing method with CAD/CAM technology simplifies the treatment and laboratory process to reduce the occurrence of errors and provides clinical efficiency and convenience. In this case, complete dentures were fabricated using stereolithography (SLA)-based 3D printing in patient with mandibular deviation. Recording base were produced in a digital model obtained with an intraoral scanner, and after recording a jaw relation in the occlusal rim, a definitive impression was obtained with polyvinyl siloxane impression material. In addition, facial scan data with occlusal rim was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a Food and Drug Administration (FDA)-approved liquid photocurable resin. The denture showed adequate retention, support and stability, and results were satisfied functionally and aesthetically.

최근 디지털 기술과 Computer-aided design/Computer-aided manufacturing (CAD/CAM) 작업 환경은 의치 제작에 있어 임상의의 진료 과정의 변화를 가져왔다. CAD/CAM 기술을 이용한 의치 제작 방식은 진료 및 기공 과정을 단순화하여 오류의 발생을 감소시키며, 임상적인 효율성과 편리함을 제공한다. 본 증례는 하악 편위를 가진 상·하악 완전 무치악 환자에서 광경화 SLA 기반의 3D 프린팅을 이용한 디지털 제작 방식의 양악 총의치 수복 증례이다. 구강 스캐너로 채득한 디지털 모형에서 기록상을 제작하였고 교합제에 악간관계를 기록한 후 부가 중합형 실리콘 인상재로 폐구 정밀 인상을 채득하였다. 또한 교합제를 장착하고 촬영한 안면 스캔 데이터를 추가로 획득하여 기공 작업 시 교합 평면 결정이나 인공치 배열에 참고할 수 있도록 하였다. 인상체를 3차원 스캔 후 CAD 프로그램을 통해 인공치를 배열하였고, 연마면을 형성하여 의치 디자인을 완성하였다. 시적 의치 및 최종 의치는 미국식품의약국(Food and Drug Administraion, FDA) 승인을 받은 액체 광경화성 레진을 이용하여 stereolithography (SLA) 기반 3D 프린터로 출력하였고, 최종 의치는 적절한 안정과 유지, 지지를 보였으며 기능적, 심미적으로 만족스러운 결과를 얻을 수 있었다.

Keywords

References

  1. The glossary of prosthodontic terms. J Prosthet Dent 2017;117:e1-e105.
  2. Dusmukhamedov S, Lee CN, Jeong SM, Choi BH. Digital denture fabrication: a technical note. Appl Sci 2021;11:8093. https://doi.org/10.3390/app11178093
  3. Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental CAD/CAM: current status and future perspectives from 20 years of experience. Dent Mater J 2009;28:44-56. https://doi.org/10.4012/dmj.28.44
  4. Bidra AS, Taylor TD, Agar JR. Computer-aided technology for fabricating complete dentures: systematic review of historical background, current status, and future perspectives. J Prosthet Dent 2013;109:361-6. https://doi.org/10.1016/S0022-3913(13)60318-2
  5. Patzelt SB, Vonau S, Stampf S, Att W. Assessing the feasibility and accuracy of digitizing edentulous jaws. J Am Dent Assoc 2013;144:914-20. https://doi.org/10.14219/jada.archive.2013.0209
  6. Kattadiyil MT, Goodacre CJ, Baba NZ. CAD/CAM complete dentures: a review of two commercial fabrication systems. J Calif Dent Assoc 2013;41:407-16.
  7. Yoshidome K, Torii M, Kawamura N, Shimpo H, Ohkubo C. Trueness and fitting accuracy of maxillary 3D printed complete dentures. J Prosthodont Res 2021;65:559-64. https://doi.org/10.2186/jpr.JPR_D_20_00240
  8. Deng K, Chen H, Zhao Y, Zhou Y, Wang Y, Sun Y. Evaluation of adaptation of the polylactic acid pattern of maxillary complete dentures fabricated by fused deposition modelling technology: A pilot study. PLoS One 2018;13:e0201777. https://doi.org/10.1371/journal.pone.0201777
  9. Lee JJ, Song KY, Park JM. Application and consideration of digital technology for removable complete denture. J Korean Dent Assoc 2019;57:534-43. https://doi.org/10.22974/JKDA.2019.57.9.006
  10. Wang C, Shi YF, Xie PJ, Wu JH. Accuracy of digital complete dentures: A systematic review of in vitro studies. J Prosthet Dent 2021;125:249-56. https://doi.org/10.1016/j.prosdent.2020.01.004