대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제60권2호
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  • Pages.175-186
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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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III급 부정교합 환자에서 상악 가철성 국소 의치와 하악 임플란트 지지 고정성 보철물을 이용한 구강 회복 증례

Rehabilitation of posterior support and vertical dimension in a class 3 malocclusion patient: A case report

  • 오지환 (강남세브란스치과병원 치과보철과) ;
  • 표세욱 (강남세브란스치과병원 치과보철과) ;
  • 장재승 (강남세브란스치과병원 치과보철과) ;
  • 김선재 (강남세브란스치과병원 치과보철과)
  • Oh, Ji-Hwan (Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University) ;
  • Pyo, Se-Wook (Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University) ;
  • Chang, Jae-Seung (Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University) ;
  • Kim, Sunjai (Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University)
  • 투고 : 2021.10.12
  • 심사 : 2021.11.02
  • 발행 : 2022.04.30
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초록

상, 하악에 잔존 치아가 있음에도 불구하고 교합 접촉이 가능한 대합 치아가 없어서 교두 감합위를 상실하게 되는 엇갈린 교합은 결과적으로 수직 고경의 붕괴를 초래한다. 본 증례에서는 엇갈린 교합 및 전치부 반대교합을 동반하는 III급 부정교합 환자를 상악 가철성 국소 의치와 하악 임플란트 지지 고정성 보철물을 이용하여 구강 회복을 진행하였다. 3개월 동안 임시의치의 착용 기간을 거쳐 수직 고경 안정화 및 심미성 개선을 위한 임시 보철물을 제작하였고, 이를 최종 수복물에 반영하기 위하여 전방 유도 테이블의 제작과 수직 고경 및 교합 관계의 유지를 위한 교차 마운팅을 시행하였다. 하악 임플란트 및 상악의 지대치는 금속 도재관을 이용하여 수복하였고, 상악의 편측성 무치악 부위는 국소 의치를 제작하였다. 단계적인 치료 과정을 통해 구치부의 적절한 지지 및 전치부의 반대교합의 해소를 통한 상호보호교합의 교합관계를 형성하였으며, 환자에게 심미적, 기능적인 치과 보철물을 장착함으로써 만족스러운 치료결과를 얻을 수 있었다.

A crossed occlusion resulting from the presence of posterior teeth in one arch but no opposing teeth in the opposite arch results in collapse of the vertical dimension. In this case, the patient has a class III malocclusion with crossed occlusion and anterior crossbite. In order to evaluate the proper vertical dimension, provisional denture was used to stabilize the vertical occlusal dimension for 3 months. After, provisional fixed restoration was used for the stabilizing occlusal relationship and aesthetic improvement for lip support. Definitive prosthesis in implants in the mandible and abutments in the maxillary were using Porcelain-fused-to-metal crown (PFM) crown and the maxillary unilateral edentulous area was treated with removable partial dentures. Through this, proper support of the posterior region and normal anterior occlusal relationship were formed, and the patient was able to obtain aesthetically and functionally satisfactory treatment results.

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참고문헌

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