상악 완전무치악 및 하악 양측 구치부 결손 고령환자에 대한 상악 가철성, 하악 고정성 보철치료: 증례보고
Treatment with upper complete denture and lower implant-fixed restorations on an elderly patient presenting fully edentulous maxilla and bilateral posterior edentulous mandible: a case report
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안정적인 구치부 교합지지는 적절한 저작기능과 정상적인 안모의 유지를 위해 매우 중요하다. 특히 65세 이상의 고령환자에서는 저작기능이 충분한 영양섭취와 환자의 전신건강에 직접적인 영향을 미친다. 본 증례에서는 상악 무치악, 하악 양측 구치부 치아 상실을 보이는 고령환자의 구치부 교합지지를 회복해주기 위해 상악 총의치를 제작하여 이상적인 교합평면을 설정하였고, 하악 양측 구치부에 컴퓨터 가이드 임플란트 식립 수술을 진행하였다. 임플란트 지지 임시 수복물을 이용한 임플란트 즉시부하를 통해 환자가 수술 후에도 음식 섭취를 원활하게 할 수 있도록 하였다. 하악 구치부 지르코니아 고정성 보철수복을 완료한 후, 상악 총의치 인공치의 교합면을 Cobalt-Chrome계 금속 합금으로 치환하여 마모 저항성을 향상시켰다. 상악 가철성 총의치, 하악 양측 구치부 고정성 보철 치료를 통해 환자의 교합지지와 저작기능을 빠르게 회복해주고, 최종 치료단계에서는 마모에 대한 장기적 안정성도 얻을 수 있었기에 이를 보고하고자 한다.
Abstract
Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient’s posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.
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