임시 보철물을 이용한 연조직 형태의 정확한 전달과 최종 보철물로의 전환
Accurate transfer of gingival morphology to definitive prostheses using temporary prostheses
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초록
높은 심미성이 요구되는 상악 전치부의 고정성 보철 치료에서 성공적인 치료 결과를 위해서는 보철물은 물론이고 대칭적이고 자연스러운 치은을 형성해주는 것이 중요하다. 심미적인 치은을 얻기 위해서는 임시 보철물의 치은연하 윤곽(subgingival contour)을 조절하거나, 가공치(pontic) 하방의 기저면 형태를 조절하는 등의 과정이 필요한데, 임시 보철물을 최종 보철물로 이행하는 과정에서 통상적인 방법으로 임시 보철물을 제거하고, 치은 압배 후 인상 채득을 하게 되면 임시 보철물이 장착된 상태의 치은 형태를 모형상에 그대로 재현하지 못한다. 이러한 경우, 모형상에서 임의로 치은을 삭제하여 최종 보철물을 제작하게 되어 심미적인 치료 결과의 예지성이 떨어지게 된다. 이에 본 증례보고에서는 임시 보철물에서 형성한 치은연하 윤곽과 가공치 하방 기저면 형태를 최종 모형 및 최종 보철물로 이행하는 방법에 대해 두 가지 증례를 통해 소개하고자 한다.
Abstract
In fixed prosthodontic treatment of the maxillary anterior region, where high esthetics are required, it is crucial not only to achieve a successful prosthesis but also to form symmetrical and natural gingiva. To achieve esthetic gingiva, it is necessary to adjust the subgingival contour of the temporary prosthesis or to modify the base of pontic. However, during the transition from temporary to definitive prosthesis, the conventional method of removing the temporary prosthesis and taking an impression after gingival retraction often fails to accurately reproduce the gingival profile. In such cases, the gingiva is arbitrarily trimmed on the model to fabricate the definitive prosthesis, which reduces the predictability of esthetic treatment outcomes. This case report introduces methods to transfer the subgingival contour and the pontic base formed with the temporary prosthesis to the final model and definitive prosthesis through two cases.
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