The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Rehabilitation of the edentulous patient with implant overdenture using CAD-CAM denture system: A case report

CAD-CAM으로 제작된 임플란트 피개의치를 이용한 무치악 환자의 보철 수복 증례

  • Lee, Han-na (Department of Dentistry, Korea University Guro Hospital) ;
  • Shim, Ji-Suk (Department of Dentistry, Korea University Guro Hospital) ;
  • Lee, Jeong-Yol (Department of Dentistry, Korea University Guro Hospital)
  • Received : 2022.08.08
  • Accepted : 2022.09.28
  • Published : 2022.10.31
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Abstract

This case report introduces a 74-year-old male patient who visited retention deficiency of the mandibular implant overdenture, which was fabricated 20 years ago. When the existing dentures were used, the vertical dimension was reduced, the maxillary complete denture lacked lip support and retention, and the mandibular overdenture lacked clip retention due to damage to the bar attachment. After removing the damaged bar attachment, it was replaced with a ball attachment, and impressions were taken using the DENTCATM Tray and then the vertical dimension was measured. The gothic arch tracing was performed to record the centric relation. Obtained impressions were scanned and the shape of final dentures was designed using software and try-in dentures were fabricated using 3D printer. After evaluating the occlusal plane, occlusal relationship, facial shape, and pronunciation using the try-in dentures, the bite registration was recorded, and the final denture was manufactured based on this. The inner surface of the denture was adjusted and bilateral balanced occlusion was formed, and the housing was connected to the mandibular denture by a direct method. This case reports have shown satisfactory resultin recovering improved retention and esthetic outcome by increasing the vertical dimension and the lip support using CAD-CAM technique and the ball attachment.

본 증례는 74세 남환으로 20년 전 제작한 하악 임플란트 피개의치의 잦은 탈락을 주소로 내원하였다. 기존 의치 사용 시 수직고경이 감소되었으며, 상악 총의치는 입술 지지 및 유지력이 부족하였으며, 하악 피개의치는 bar attachment 손상으로 clip의 유지력 부족이 관찰되었다. 손상된 bar attachment를 제거 후 ball attachment로 교체하였으며, DENTCATM Tray를 이용하여 인상 채득, 수직고경을 측정하고, 고딕 아치 기록방법으로 중심위를 결정하여 교합기록을 시행하였다. 채득한 인상체를 스캔하여 소프트웨어를 이용하여 최종 의치의 형태를 디자인하였고, 3D 프린터로 시적의치를 제작하였다. 제작된 시적의치를 장착하여 교합평면 및 교합관계, 안모 형태, 발음 등을 평가한 후 교합기록을 하였으며, 이를 바탕으로 최종 의치를 제작하였다. 최종 의치의 내면 조정 및 양측성 균형교합을 형성하였으며, 하악 의치에서는 직접법으로 attachment를 연결하였다. 새로 제작된 상하악 의치 사용 시, 수직고경의 증가 및 입술지지를 회복하여 개선된 안모가 관찰되었으며, ball attachment 교체로 하악 임플란트 피개의치의 유지력이 증가하여 기능적으로도 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

Keywords

Acknowledgement

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project number : KMDF_PR_20200901_0245)

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