The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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A case of oral rehabilitation with increasing vertical dimension for a patient with loss of posterior teeth support

구치부 지지 상실을 보이는 환자에서 수직고경 거상을 동반한 구강 회복 증례

  • Kim, Hyun-Hwi (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Lee, Jong-Hyuk (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Ha, Seung-Ryong (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Choi, Yu-Sung (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 김현휘 (단국대학교 치과대학 치과보철학교실) ;
  • 이종혁 (단국대학교 치과대학 치과보철학교실) ;
  • 하승룡 (단국대학교 치과대학 치과보철학교실) ;
  • 최유성 (단국대학교 치과대학 치과보철학교실)
  • Received : 2022.08.11
  • Accepted : 2022.09.21
  • Published : 2022.10.31
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Abstract

The patient in this case was an 80-year-old female who had lost #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 teeth. The patient showed loss of posterior support, loss of vertical dimension of occlusion, and deep anterior overbite. Her chief complaint was esthetic and functional discomfort. She wanted to restore normal facial aesthetic shape and masticatory function through prosthetic treatment. Clinical evaluation, radiographic examinations, and facial and oral analysis were performed. Interocclusal rest space was excessive than the average. Distance between labial vestibules and zenith of central incisors, and lower facial ratio were below the average. Taken together, occlusal rehabilitation was determined through increasing 4 mm of vertical dimension on premolars. In this case, a patient who lacked restoration space with deep bite in the anterior region due to loss of the posterior teeth support restored a stable occlusal relationship and harmonious anterior and lateral guidance through fixed and removable prosthesis with increased vertical dimension.

본 증례의 환자는 80세 여성으로 #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 치아가 상실되었으며, 하악 구치부의 결손으로 상실된 구치부 지지와 감소한 수직교합고경 및 전치부의 심한 수직피개를 보였다. 심미 및 기능상의 불편을 호소하였고, 보철치료를 통한 정상적인 안모 및 저작기능 회복을 주소로 내원하였다. 임상 소견, 방사선 검사, 안모 및 구내 분석 등을 시행하였다. 교합안정공극은 평균보다 과도하였고 상하악 전치 치은연 사이 거리 및 상하악 순측 전정 사이 거리, 하안면의 비율은 부족하여 수직고경 증가가 필요한 경우로 판단하였다. 소구치부 기준 약 4 mm의 수직고경 거상을 통한 교합 회복을 결정하였다. 본 증례에서는 구치부를 상실하여 전치부의 deep bite 및 수복공간의 부족을 보이는 환자에서 수직고경 거상 및 고정성, 가철성 보철물을 이용한 수복으로 안정된 교합관계 및 전방, 측방유도를 형성하여 환자의 심미적, 기능적인 수복 결과를 이끌어냈기에 이를 보고하는 바이다.

Keywords

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