대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제60권2호
  • /
  • Pages.222-230
  • /
  • 2022
  • /
  • 0301-2875(pISSN)
  • /
  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
권호 표지
DOI QR코드

DOI QR Code

심미치의학 영역에서 동적 교합을 나타내는 가상 환자의 형성을 통한 전치부 보철 수복 증례

Creation of the dental virtual patients with dynamic occlusion and its application in esthetic dentistry

  • 안세준 (단국대학교 치과대학 치과보철학교실) ;
  • 신수연 (단국대학교 치과대학 치과보철학교실) ;
  • 최유성 (단국대학교 치과대학 치과보철학교실)
  • An, Se-Jun (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Shin, Soo-Yeon (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 투고 : 2022.02.03
  • 심사 : 2022.03.31
  • 발행 : 2022.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

디지털 기술은 점차 그 영역을 넓혀 치의학의 여러 분야에 큰 영향을 미치고 있다. 최근 디지털 치의학에서는 다양한 삼차원적(3D) 이미지 데이터를 하나로 중첩시켜 진단 및 보철물 제작에 활용하는 것의 중요성이 대두되고 있다. 안면 스캔, 구내 스캔, 하악 운동 기록(mandibular movement recording) 등의 데이터를 통합하면 가상 환자 모델을 구성할 수 있다. 가상 환자(Virtual patient)란 구내 및 구외 연조직, 잔존 치열, 동적 교합 등 디지털 3D 진단 데이터를 통합하여 형성되며 이를 통해 보철 치료의 결과 등을 가상으로 시뮬레이션을 시행할 수 있다. 본 증례에서의 환자는 37세 여성 및 55세 여성 환자로 각각 기존 보철물의 외형이 틀어진 것 같다는 주소와 근관치료 후 전치부 보철물의 재제작을 주소로 내원하였다. 각 환자에서 3D 안면 스캔을 채득하였으며, ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany)를 통해 환자의 하악 운동을 기록하였다. 수집한 데이터를 computer-aided design (CAD) 소프트웨어(Exocad dental CAD; exocad GmbH, Darmstadt, Germany) 상에서 하나로 통합하여 가상 교합기에 옮겨 디지털 가상 환자를 형성하였다. 이를 통해 임시 고정성 보철물을 디자인하고 수복하여 평가하였으며, 최종수복물로 옮겨 심미적, 기능적으로 만족할 만한 결과를 보였기에 이를 보고하고자 한다.

Digital technology is gradually expanding its field and has a great influence on various fields of dentistry. Recently in digital dentistry, the importance of superimposing various 3-dimensional (3D) image data is emerging, in order to utilize gathered data effectively for diagnosis and prosthesis fabrication. Integrating data from facial scans, intraoral scans, and mandibular movement recordings can create a virtual patient. A virtual patient is formed by integrating digital 3D diagnostic data such as intraoral and extraoral soft tissues, residual dentition, and dynamic occlusion, and the results of prosthetic treatment can be evaluated virtually. The patients in this case report were a 37-year-old female whose chief complaint is that the appearance of the existing prosthesis was distorted and a 55-year-old female patient whose anterior prosthesis needed to be refabricated after the endodontic treatment. 3D facial scans were obtained from each patient, and the patient's mandibular movements were recorded using ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany). The collected data were integrated on computer-aided design (CAD) software (Exocad dental CAD; exocad GmbH, Darmstadt, Germany) and transferred to a virtual articulator to create a digital virtual patient. The temporary fixed prostheses were designed, restored, and evaluated, and it was reflected into the final restorations. With the aid of the virtual dental patient, accuracy and predictability could be increased throughout treatment, simplifying the occlusal adjustment and clinical evaluation with improved esthetic outcomes.

키워드

과제정보

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (NRF-2021R1F1A1048462).

참고문헌

  1. Kim JE, Park JH, Moon HS, Shim JS. Complete assessment of occlusal dynamics and establishment of a digital workflow by using target tracking with a three-dimensional facial scanner. J Prosthodont Res 2019;63:120-4. https://doi.org/10.1016/j.jpor.2018.10.003
  2. Li Q, Bi M, Yang K, Liu W. The creation of a virtual dental patient with dynamic occlusion and its application in esthetic dentistry. J Prosthet Dent 2021;126:14-8. https://doi.org/10.1016/j.prosdent.2020.08.026
  3. Lo Russo L, Salamini A. Removable complete digital dentures: A workflow that integrates open technologies. J Prosthet Dent 2018;119:727-32. https://doi.org/10.1016/j.prosdent.2017.06.019
  4. Lin WS, Harris BT, Phasuk K, Llop DR, Morton D. Integrating a facial scan, virtual smile design, and 3D virtual patient for treatment with CAD-CAM ceramic veneers: A clinical report. J Prosthet Dent 2018;119:200-5. https://doi.org/10.1016/j.prosdent.2017.03.007
  5. Joda T, Gallucci GO. The virtual patient in dental medicine. Clin Oral Implants Res 2015;26:725-6. https://doi.org/10.1111/clr.12379
  6. Solaberrieta E, Garmendia A, Minguez R, Brizuela A, Pradies G. Virtual facebow technique. J Prosthet Dent 2015;114:751-5. https://doi.org/10.1016/j.prosdent.2015.06.012
  7. Lam WY, Hsung RT, Choi WW, Luk HW, Pow EH. A 2-part facebow for CAD-CAM dentistry. J Prosthet Dent 2016;116:843-7. https://doi.org/10.1016/j.prosdent.2016.05.013
  8. Hong SJ, Noh K. Setting the sagittal condylar inclination on a virtual articulator by using a facial and intraoral scan of the protrusive interocclusal position: A dental technique. J Prosthet Dent 2021;125:392-5. https://doi.org/10.1016/j.prosdent.2020.01.031
  9. Joda T, Bragger U, Gallucci G. Systematic literature review of digital three-dimensional superimposition techniques to create virtual dental patients. Int J Oral Maxillofac Implants 2015;30:330-7. https://doi.org/10.11607/jomi.3852
  10. Revilla-Leon M, Raney L, Piedra-Cascon W, Barrington J, Zandinejad A, Ozcan M. Digital workflow for an esthetic rehabilitation using a facial and intraoral scanner and an additive manufactured silicone index: A dental technique. J Prosthet Dent 2020;123:564-70. https://doi.org/10.1016/j.prosdent.2019.03.014
  11. Park C. Application of ARCUS digma I, II systems for full mouth reconstruction: a case report. J Dent Rehabil Appl Sci 2016;32:345-50. https://doi.org/10.14368/jdras.2016.32.4.345
  12. Hong YT, Koak JY, Kim SK, Heo SJ. Digital duplication of provisional prosthesis to fabricate definitive prosthesis for full mouth rehabilitation using double scan technique. J Korean Acad Prosthodont 2021;59:63-70. https://doi.org/10.4047/jkap.2021.59.1.63