대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제61권4호
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  • Pages.293-307
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  • 2023
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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심한 교모와 구치부 상실을 보이는 환자의 전악 수복: Jaw motion tracking과 digital workflow를 활용한 증례 보고

Full-mouth rehabilitation of severely attrited dentition with missing posterior teeth: a case report using digital workflow with jaw motion tracking

  • 박찬영 (경희대학교 치과병원 보철과) ;
  • 이영후 (경희대학교 치과병원 보철과) ;
  • 홍성진 (경희대학교 치과대학 치과보철학교실) ;
  • 백장현 (경희대학교 치과대학 치과보철학교실) ;
  • 노관태 (경희대학교 치과대학 치과보철학교실) ;
  • 배아란 (경희대학교 치과대학 치과보철학교실) ;
  • 김형섭 (경희대학교 치과대학 치과보철학교실) ;
  • 권긍록 (경희대학교 치과대학 치과보철학교실)
  • Chan Young Park (Department of Prosthodontics, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Younghoo Lee (Department of Prosthodontics, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center) ;
  • Seoung-Jin Hong (Department of Prosthodontics, College of Dentistry, Kyung Hee University) ;
  • Janghyun Paek (Department of Prosthodontics, College of Dentistry, Kyung Hee University) ;
  • Kwantae Noh (Department of Prosthodontics, College of Dentistry, Kyung Hee University) ;
  • Ahran Pae (Department of Prosthodontics, College of Dentistry, Kyung Hee University) ;
  • Hyeong-Seob Kim (Department of Prosthodontics, College of Dentistry, Kyung Hee University) ;
  • Kung-Rock Kwon (Department of Prosthodontics, College of Dentistry, Kyung Hee University)
  • 투고 : 2023.08.08
  • 심사 : 2023.09.05
  • 발행 : 2023.10.31
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초록

최근 다양한 증례 보고에서 소개되고 있는 jaw motion tracking은 환자의 안궁 이전 및 개별화된 하악 운동 경로를 기록한 후, 이를 computer-aided-design/computer-aided-manufacturing (CAD-CAM) 소프트웨어의 가상공간상에 재현하는 방법이다. 본 증례의 환자는 오랜 기간 구치부의 상실로 인해 교합평면의 붕괴가 관찰되었기에, 수직 교합 고경의 증가를 동반한 완전 구강 회복술을 계획하였다. 우선 jaw motion tracking을 진행하여 새로운 중심위 상에서 환자의 하악 운동을 기록한 후, 이 정보를 환자의 초진 구내 데이터 및 3차원 안면 스캔 데이터와 조합하여 가상 환자를 생성하였다. 가상 환자 상에서 진행한 디지털 왁스업과 임플란트 식립 계획을 바탕으로 임시 보철물을 제작하였다. 새롭게 설정된 수직 교합 고경 상에서 적절한 견치 유도를 보이는 임시 보철물의 검증을 통해, 최종 보철물로 이행하였다. 이처럼 디지털 치의학 기술의 장점을 활용하여 환자는 저작능과 심미성의 개선에 만족하였기에 본 증례를 보고하고자 한다.

Jaw motion tracking, which is introduced in recent case reports, is a method which records the patient's individualized pathway of the mandibular movements along with facebow transfer, and reproduces the information in the virtual space of computer-aided-design/computer-aided-manufacturing (CAD-CAM) software. In this present case, a collapse of the occlusal plane was observed, due the loss of posterior teeth for a long period. Full-mouth rehabilitation with an increase in the occlusal vertical dimension was planned. First, the patient's mandibular movements were recorded on the newly established jaw relation by jaw tracking, and this information was assembled with the patient's intraoral data to create a virtual patient. Implant planning and diagnostic wax-up was done on the virtual patient, leading the fabrication of the provisional prosthesis. On the newly established jaw relation with an increase in the occlusal vertical dimension, canine guidance of the provisional prosthesis was checked. Finally, the provisional prosthesis was carried out to the definitive prosthesis. Using the advantages of the technologies in the digital dentistry, the patient was satisfied with the function and the esthetics after the treatment.

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