다발성 안면 골절 환자의 보철 수복을 위한 디지털 워크플로우: 증례보고
Digital workflow for prosthetic restoration in the pan facial fracture patient: A case report
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다발성 안면 골절의 경우 골절 부위를 원위치로 정복하기 위한 지표가 부족하기에 골절편의 정복 후 교합과 구강 구조의 형태 및 위치가 비정상적으로 변화된 결과를 보이는 경우가 많이 나타난다. 그리고 다발성 안면 골절환자에서 나타난 개구제한과 구역반사는 치과 치료의 난이도를 높이고, 외상으로 인한 악골의 위치차이가 심미적, 기능적 회복을 어렵게 한다. 이러한 경우 환자의 불편감과 치과치료의 난이도를 줄이기 위해 최소한의 구내작업을 위한 디지털 워크플로우를 선택할 수 있다. 본 증례는 15년전 발생한 다발성 안면골절로 인한 후천적인 골격성 III급 및 개구제한, 구역반사를 가진 환자에서 상악 전치부 무치악상태를 임플란트 계획부터 최종 보철물의 제작까지 디지털 워크플로우를 이용하여 수복한 증례이다. 이러한 치과치료의 어려움이 있는 환자에서 디지털 워크플로우의 사용이 환자의 불편감을 최소로 하고 심미적, 기능적으로 적절한 결과를 얻었기에 이를 보고하는 바이다.
Abstract
In the fracture operation of pan facial fracture, there are many cases where the shape and position of the occlusal and oral structures are abnormally changed because the index for repositioning to the original position is insufficient. And trismus and gag reflex in patients with pan facial fractures increase the difficulty of dental treatment, and the difference in the position of the jaw bone makes it difficult to restore aesthetically and functionally. In this case, digital workflows for minimal intraoral work could be selected to reduce patient discomfort and the difficulty of dental treatment. This case is using a digital workflow from implant planning to final prosthesis production in a patient with acquired skeletal grade III, trismus, and gag reflex due to pan facial fracture 15 years ago. In this case report, the use of digital workflow in a patient who has difficulty in dental treatment was able to minimize patient discomfort and obtain esthetic and functionally appropriate results.
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