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Implant-assisted removable partial denture using Milled-Bar and Attachment in partially edentulous maxilla: A case report

상악 부분 무치악 환자에서 Milled-bar와 어태치먼트를 이용한 임플란트 부분 피개의치 수복 증례 보고

  • Jeong, Yun-Su (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Jeong, Chang-Mo (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Yun, Mi-Jung (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Lee, So-Hyoun (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Huh, Jung-Bo (Department of Prosthodontics, School of Dentistry, Pusan National University)
  • 정윤수 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 정창모 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 윤미정 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 이소현 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 허중보 (부산대학교 치의학전문대학원 치과보철학교실)
  • Received : 2022.08.23
  • Accepted : 2022.09.29
  • Published : 2022.10.31

Abstract

For treatment of partially edentulous patients, a treatment using implant is widely used. Treatment method using implant are implant fixed prostheses and removable partial dentures, and for patients with severe bone resorption, removable implant overdenture with the effects of aesthetic and reducing cost can be used as treatment options. Specially, prosthesis with milled-bar and attachment has the effect of being splinted between implant fixtures, higher retention and stability than conventional removable partial denture. And it has the effect of improvement of aesthetic through lip support by denture base. In this case, the patient with severe alveolar bone resorption and partial edentulous maxilla and mandible was treated by implant-assisted removable partial denture using Milled-bar and ADD-TOC attachment. The esthetic was improved by removing the clasp because of effects of additional retention by using the attachment, and reducing palatal coverage of implant-assisted removable partial denture. The clinical results were satisfactory on the aspect of aesthetic and masticatory function.

부분 무치악 환자의 구강회복을 위해서는 임플란트를 이용한 치료 방법이 널리 활용되고 있다. 임플란트를 이용한 치료방법은 크게 고정성 임플란트 보철물과 가철성 임플란트 보철물로 나뉠 수 있으며, 골 흡수가 심한 환자의 경우 심미적이고 경제적인 이점을 갖는 가철성 임플란트 보철물이 치료 옵션으로 활용될 수 있다. 특히 소수의 임플란트에 Milled-bar와 부가적인 유지장치를 이용한 보철물 제작 시, 임플란트 고정체 간의 연결고정 효과 및 의치의 유지력과 안정성이 증가할 수 있다. 또한 의치상을 통한 구순 지지를 통해 심미적인 보철물 제작이 가능하다. 본 증례의 환자는 상악골의 심한 골 흡수를 동반한 소수의 잔존치를 갖는 부분 무치악 환자로 전치부 및 소구치부위에 임플란트를 3개 식립 후 캐드캠을 이용하여 제작된 Milled-bar와 ADD-TOC 어태치먼트를 이용한 임플란트 부분 피개의치로 치료하였다. 그 결과 어태치먼트를 이용한 clasp 제거 및 의치상을 이용한 구순 지지를 통해 심미성을 높였으며, Milled-bar를 통한 교합력 지지와 의치 안정성을 확보하였다. 또한 환자의 이물감 해소를 위해 구개부 피개량을 줄인 금속 구조물의 피개의치를 제작하였으며, 만족스러운 결과를 얻었기에 보고하는 바이다.

Keywords

Acknowledgement

This work was supported by a 2-Year Research Grant of Pusan National University.

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