디지털 안궁이전과 가상교합기를 이용하여 하악의 운동을 고려한 구치부 수복 증례
Posterior rehabilitation considering mandibular movement with digital facebow transfer and virtual articulator: A case report
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디지털 안궁이전 장치로 하악의 운동로를 기록하고 캐드 소프트웨어(CAD software) 상에 반영할 수 있는데 이를 고려한 보철 수복은 치료 결과를 향상시킨다. 본 증례는 상하악대구치가 소실된 환자에서 디지털 기술을 활용하여 임플란트를 식립 및 보철 수복한 증례이다. 구내 스캔 후 디지털 진단 왁스업을 토대로 임플란트 수술용 가이드를 제작한 뒤 임플란트 식립했다. 6개월의 충분한 골유착 후, 맞춤형 지대주와 첫번째 임시 보철물을 장착하였다. 2개월 후 지대주 수준에서 구강 스캔 및 디지털 안궁이전 장치로 가상 교합기 상마운팅하고 하악 운동을 기록했다. 하악의 움직임을 고려하여 두번째 임시 보철물을 제작,장착 후 안정된 교합 상태에서 더블 스캔 과정으로 복제하여 지르코니아 최종 보철물을 디자인하고 장착했다.
Abstract
The digital facebow device records the trajectory of the mandibular movement where it is then reflected on the computer-aided design software, leading to an improvement on treatment outcomes of prosthetic restorations. In this clinical case, using a digital technology, an implant placement and prosthetic restoration were done in a patient who has lost maxillary and mandibular molars. Following an intraoral scan, a surgical stent for implant surgery was fabricated based on digital diagnostic wax-up, and implants were installed. After six months of sufficient osseointegration, customized abutments and the first temporary prostheses were delivered. Then two months later, at an abutment level, an intraoral scan and digital facebow transfer device were used to mount the intraoral scan data on a virtual articulator, and record the mandibular movements. Once the second temporary prostheses were fabricated and delivered on a basis of the mandibular movement, the definitive zirconia prostheses were designed and delivered based on a stabilized occlusion that was duplicated via double scan technique.
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