The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Digital workflow for prosthetic restoration in the pan facial fracture patient: A case report

다발성 안면 골절 환자의 보철 수복을 위한 디지털 워크플로우: 증례보고

  • Kim, Seung-Wan (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Geun-Taek (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University) ;
  • Huh, Yoon-Hyuk (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University) ;
  • Ko, Kyung-Ho (Department of Prosthodontics, College of Dentistry, Gangneung-Wonju National University)
  • 김승완 (강릉원주대학교 치과대학 치과보철학교실) ;
  • 박근택 (강릉원주대학교 치과대학 치과보철학교실) ;
  • 허윤혁 (강릉원주대학교 치과대학 치과보철학교실) ;
  • 박찬진 (강릉원주대학교 치과대학 치과보철학교실) ;
  • 조리라 (강릉원주대학교 치과대학 치과보철학교실) ;
  • 고경호 (강릉원주대학교 치과대학 치과보철학교실)
  • Received : 2022.08.11
  • Accepted : 2022.09.15
  • Published : 2022.10.31
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Abstract

In the fracture operation of pan facial fracture, there are many cases where the shape and position of the occlusal and oral structures are abnormally changed because the index for repositioning to the original position is insufficient. And trismus and gag reflex in patients with pan facial fractures increase the difficulty of dental treatment, and the difference in the position of the jaw bone makes it difficult to restore aesthetically and functionally. In this case, digital workflows for minimal intraoral work could be selected to reduce patient discomfort and the difficulty of dental treatment. This case is using a digital workflow from implant planning to final prosthesis production in a patient with acquired skeletal grade III, trismus, and gag reflex due to pan facial fracture 15 years ago. In this case report, the use of digital workflow in a patient who has difficulty in dental treatment was able to minimize patient discomfort and obtain esthetic and functionally appropriate results.

다발성 안면 골절의 경우 골절 부위를 원위치로 정복하기 위한 지표가 부족하기에 골절편의 정복 후 교합과 구강 구조의 형태 및 위치가 비정상적으로 변화된 결과를 보이는 경우가 많이 나타난다. 그리고 다발성 안면 골절환자에서 나타난 개구제한과 구역반사는 치과치료의 난이도를 높이고, 외상으로 인한 악골의 위치차이가 심미적, 기능적 회복을 어렵게 한다. 이러한 경우 환자의 불편감과 치과치료의 난이도를 줄이기 위해 최소한의 구내작업을 위한 디지털 워크플로우를 선택할 수 있다. 본 증례는 15년전 발생한 다발성 안면골절로 인한 후천적인 골격성 III급 및 개구제한, 구역반사를 가진 환자에서 상악 전치부 무치악 상태를 임플란트 계획부터 최종 보철물의 제작까지 디지털 워크플로우를 이용하여 수복한 증례이다. 이러한 치과치료의 어려움이 있는 환자에서 디지털 워크플로우의 사용이 환자의 불편감을 최소로 하고 심미적, 기능적으로 적절한 결과를 얻었기에 이를 보고하는 바이다.

Keywords

References

  1. De Riu G, Gamba U, Anghinoni M, Sesenna E. A comparison of open and closed treatment of condylar fractures: a change in philosophy. Int J Oral Maxillofac Surg 2001;30:384-9. https://doi.org/10.1054/ijom.2001.0103
  2. Wusiman P, Maimaitituerxun B, Guli, Saimaiti A, Moming A. Epidemiology and Pattern of Oral and Maxillofacial Trauma. J Craniofac Surg 2020;31:e517-20. https://doi.org/10.1097/SCS.0000000000006719
  3. Throckmorton GS, Ellis E 3rd. Recovery of mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. Int J Oral Maxillofac Surg 2000;29:421-7. https://doi.org/10.1016/S0901-5027(00)80072-7
  4. Sforza C, Tartaglia GM, Lovecchio N, Ugolini A, Monteverdi R, Gianni AB, Ferrario VF. Mandibular movements at maximum mouth opening and EMG activity of masticatory and neck muscles in patients rehabilitated after a mandibular condyle fracture. J Craniomaxillofac Surg 2009;37:327-33. https://doi.org/10.1016/j.jcms.2009.01.002
  5. Wenig BL. Management of panfacial fractures. Otolaryngol Clin North Am 1991;24:93-101. https://doi.org/10.1016/S0030-6665(20)31168-3
  6. Tullio A, Sesenna E. Role of surgical reduction of condylar fractures in the management of panfacial fractures. Br J Oral Maxillofac Surg 2000;38:472-6. https://doi.org/10.1054/bjom.1999.0236
  7. Ali K, Lettieri SC. Management of panfacial fracture. Semin Plast Surg 2017;31:108-17. https://doi.org/10.1055/s-0037-1601579
  8. Pae A, Choi CH, Noh K, Kwon YD, Kim HS, Kwon KR. The prosthetic rehabilitation of a panfacial fracture patient after reduction: a clinical report. J Prosthet Dent 2012;108:123-8. https://doi.org/10.1016/S0022-3913(12)60118-8
  9. Goyal G. Gag reflex: causes and management. Int J Dent Med Res 2014;1:163-6.
  10. Stefos S, Zoidis P, Nimmo A. Managing gag reflex during removable partial denture treatment: a review and a clinical report. J Prosthodont 2019;28:618-22. https://doi.org/10.1111/jopr.12957
  11. Logozzo S, Franceschini G, Kilpela A, Caponi M, Governi L, Blois L. A comparative analysis of intraoral 3D digital scanners for restorative dentistry. Internet J Med Technol 2011;5:1-2.
  12. Lim JH, Park JM, Kim M, Heo SJ, Myung JY. Comparison of digital intraoral scanner reproducibility and image trueness considering repetitive experience. J Prosthet Dent 2018;119:225-32. https://doi.org/10.1016/j.prosdent.2017.05.002
  13. Ting-Shu S, Jian S. Intraoral digital impression technique: a review. J Prosthodont 2015;24:313-21. https://doi.org/10.1111/jopr.12218
  14. Revilla-Leon M, Sanchez-Rubio JL, Besne-Torre A, Ozcan M. A report on a diagnostic digital workflow for esthetic dental rehabilitation using additive manufacturing technologies. Int J Esthet Dent 2018; 13:184-96.
  15. de Paris Matos T, Wambier LM, Favoreto MW, Rezende CEE, Reis A, Loguercio AD, Gonzaga CC. Patient-related outcomes of conventional impression making versus intraoral scanning for prosthetic rehabilitation: A systematic review and meta-analysis. J Prosthet Dent 2021:S0022-3913(21)00493-5.
  16. Kihara H, Hatakeyama W, Komine F, Takafuji K, Takahashi T, Yokota J, Oriso K, Kondo H. Accuracy and practicality of intraoral scanner in dentistry: A literature review. J Prosthodont Res 2020;64:109-13. https://doi.org/10.1016/j.jpor.2019.07.010
  17. Gibelli D, Cappella A, Dolci C, Sforza C. 3D surface acquisition systems and their applications to facial anatomy: let's make a point. Italian J Anat Embryol 2019;124:422-31.
  18. Kau CH, Richmond S, Incrapera A, English J, Xia JJ. Three-dimensional surface acquisition systems for the study of facial morphology and their application to maxillofacial surgery. Int J Med Robot 2007;3:97-110. https://doi.org/10.1002/rcs.141
  19. Tzou CH, Artner NM, Pona I, Hold A, Placheta E, Kropatsch WG, Frey M. Comparison of three-dimensional surface-imaging systems. J Plast Reconstr Aesthet Surg 2014;67:489-97. https://doi.org/10.1016/j.bjps.2014.01.003
  20. Park JM, Oh KC, Shim JS. Integration of intraoral digital scans with a 3D facial scan for anterior tooth rehabilitation. J Prosthet Dent 2019;121:394-7. https://doi.org/10.1016/j.prosdent.2018.03.018
  21. Lepidi L, Galli M, Mastrangelo F, Venezia P, Joda T, Wang HL, Li J. Virtual articulators and virtual mounting procedures: where do we stand? J Prosthodont 2021;30:24-35. https://doi.org/10.1111/jopr.13240
  22. Schendel SA, Lane C. 3D orthognathic surgery simulation using image fusion. Semin Orthod 2009;15:48-56. https://doi.org/10.1053/j.sodo.2008.09.012
  23. Jung J, Lee CH, Lee JW, Choi BJ. Three dimensional evaluation of soft tissue after orthognathic surgery. Head Face Med 2018;14:21. https://doi.org/10.1186/s13005-018-0179-z
  24. Perez-Giugovaz MG, Sadeghpour M, Revilla-Leon M. Virtual 3-dimensional representation of a completely edentulous patient for computer-aided static implant planning. J Prosthet Dent 2021:S0022-3913(21)00355-3.
  25. Lo Russo L, Caradonna G, Biancardino M, De Lillo A, Troiano G, Guida L. Digital versus conventional workflow for the fabrication of multiunit fixed prostheses: A systematic review and meta-analysis of vertical marginal fit in controlled in vitro studies. J Prosthet Dent 2019;122:435-40. https://doi.org/10.1016/j.prosdent.2018.12.001
  26. Parize H, Dias Corpa Tardelli J, Bohner L, Sesma N, Muglia VA, Candido Dos Reis A. Digital versus conventional workflow for the fabrication of physical casts for fixed prosthodontics: A systematic review of accuracy. J Prosthet Dent 2022;128:25-32. https://doi.org/10.1016/j.prosdent.2020.12.008
  27. Siqueira R, Chen Z, Galli M, Saleh I, Wang HL, Chan HL. Does a fully digital workflow improve the accuracy of computer-assisted implant surgery in partially edentulous patients? A systematic review of clinical trials. Clin Implant Dent Relat Res 2020;22:660-71. https://doi.org/10.1111/cid.12937
  28. Mangano C, Luongo F, Migliario M, Mortellaro C, Mangano FG. Combining intraoral scans, cone beam computed tomography and face scans: the virtual patient. J Craniofac Surg 2018;29:2241-6. https://doi.org/10.1097/SCS.0000000000004485
  29. Ramaglia L, Toti P, Sbordone C, Guidetti F, Martuscelli R, Sbordone L. Implant angulation: 2-year retrospective analysis on the influence of dental implant angle insertion on marginal bone resorption in maxillary and mandibular osseous onlay grafts. Clin Oral Investig 2015;19:769-79. https://doi.org/10.1007/s00784-014-1275-5
  30. Dawson PE. Functional occlusion: from TMJ to smile design. 1st ed. New York; Elsevier Health Sciences; 2006. p. 514-24.
  31. Cheung MC, Hopcraft MS, Darby IB. Patient-reported oral hygiene and implant outcomes in general dental practice. Aust Dent J 2021;66:49-60. https://doi.org/10.1111/adj.12806