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Implant-supported fixed prosthesis restoration of fully edentulous patient using computer-guided implant surgery and immediate loading: A case report

Computer guided implant surgery와 immediate loading을 활용한 무치악 환자의 전악 임플란트 고정성 보철물 수복 증례

  • Hyeon-Me Sung (Department of Prosthodontics, Implant Clinics, Dong-a University Medical Center) ;
  • Kyoung-Hee Sul (Department of Prosthodontics, Implant Clinics, Dong-a University Medical Center) ;
  • Sun-Woo Kang (Department of Prosthodontics, Implant Clinics, Dong-a University Medical Center) ;
  • Jung-Han Kim (Department of Oral and Maxillofacial Surgery, Implant Clinics, Dong-a University Medical Center)
  • 성현미 (동아대학교 의과대학 치과보철학교실) ;
  • 설경희 (동아대학교 의과대학 치과보철학교실) ;
  • 강선우 (동아대학교 의과대학 치과보철학교실) ;
  • 김정한 (동아대학교 의과대학 구강악안면외과학교실)
  • Received : 2023.09.26
  • Accepted : 2023.11.07
  • Published : 2024.04.30

Abstract

In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

Keywords

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