전통적 제작법과 모놀리식(monolithic) 디지털 의치 시스템을 이용한 상·하악 총의치 동시 수복 증례
Fabrication of complete denture using conventional method and monolithic digital denture system: a case report
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초록
Computer aided design/Computer aided manufacturing (CAD-CAM) 기술의 발전에 따라 이를 활용한 총의치 제작 방법이 대두되고 있으며, 그 중 하나로 의치상과 인공치의 색조를 모두 포함하는 모놀리식 블록을 절삭하는 디지털 의치 시스템이 소개되었다. 본 증례는 74세 남성, 73세 여성 두 환자에서 전통적인 기존 의치 제작법, 디지털 방식의 모놀리식 블록을 절삭한 의치 제작법으로 각각 총 두 쌍의 상·하악 의치를 제작하여 비교한 증례이다. 디지털 방식의 총의치 제작 과정으로는 CAD-CAM 프로그램으로 개인 트레이를 디자인 및 3D프린팅 하여 최종인상 및 악간 관계 채득하였다. 이후 동일한CAD-CAM프로그램으로 총의치 디자인 및 시적의치를 3D 프린팅 하여 시적 하였다. 최종적으로는 모놀리식 블록(Ivotion, Ivoclar Vivadent, Schaan, Liechtenstein)을 밀링 기계(PrograMill PM7, Ivoclar Vivadent, Schaan, Liechtenstein)로 절삭하여 총의치 제작 및 장착하였다. 해당 증례에서는 CAD-CAM 시스템을 이용한 총의치 제작과 동시에 전통적 방법으로도 총의치를 제작하여2쌍의 의치의 안정 및 적합성, 발음, 저작, 심미성과 환자의 만족도를 비교, 분석하여 이를 보고하고자 한다.
Abstract
With the advancement of Computer-Aided Design/Computer-Aided Manufacturing (CAD-CAM) technology, fabrication of dentures using this technology has gained popularity. As one of CAD-CAM technologies, digital complete denture system has been introduced, which fabricates complete dentures using subtractive manufacturing of monolithic block containing both the color of a denture base and an artificial tooth. In this case, two pairs of upper and lower dentures were fabricated for two patients. Two pairs of complete dentures were fabricated for a 74-year-old male and a 73-year-old female respectively by conventional denture fabrication method and digital method of milling. To obtain a digital complete denture, monolithic block (Ivotion, Ivoclar Vivadent, Schaan, Liechtenstein) was chosen for the materials to fabricate the digital complete dentures. An individual tray was designed using CAD software and manufactured by 3D printing technique. The final impression and interocclusal relationship were recorded using the fabricated individual tray. The final impression was scanned, and the complete denture design and try-in denture were 3D printed using CAD-CAM software. Subsequently, the monolithic block was milled, and the final dentures were fabricated and tried on patients. Previously mentioned two patient cases compared and analyzed stability, fit, speaking, mastication, aesthetics, and patient satisfaction of two pairs of dentures: one fabricated using CAD-CAM system and the other using traditional methods. This was performed to evaluate and report the findings from both denture-making approaches.
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