임플란트 고정성 보철물을 이용한 가철성 국소의치의 합병증에 관한 임상적 평가
Clinical evaluation of the removable partial dentures with implant fixed prostheses
1
조회
0
다운로드
10
인용
0
참고문헌
키워드
초록
목적: 임플란트 지지 서베이드 고정성 보철물을 이용한 가철성 국소의치의 합병증을 임상적으로 조사하고, 임플란트 식립위치, 보철물 연결고정여부, 국소의치의 유지장치 종류, 케네디 분류, 대합치에 따른 연관 관계를 조사하고자 하였다. 대상 및 방법: 2000년부터 2016년까지 임플란트 고정성 서베이드 보철물을 이용한 가철성 국소의치로 수복을 받은 환자 11명(남자 7명, 여자 4명)을 대상으로 하였다. 평균 연령은 67.5세였으며, 상악 7개, 하악 4개의 국소의치가 제작되었다. 장착된 국소의치 11개와 이를 지지하는 37개의 임플란트 고정성 보철물의 기계적 합병증, 잔존 자연치아 상태, 주변 연조직 상태 등 모든 합병증과 그와 관련된 요소를 조사하였다. 결과: 장착된 국소의치 11개를 지지하는 총 임플란트는 37개로 국소의치마다 평균 3.4 개의 임플란트 지지 서베이드 고정성 보철물이 이용되었다. 평균 41.5 개월의 추시 기간 동안 발생한 합병증은 임시시멘트 접착 탈락, 대합치 파절/동요, 나사 파절, 나사 풀림, 클래스프 헐거움, 상부 도재파절, 임플란트 주위 골 흡수/동요, 국소의치 인공치아 파절 순으로 발생하였다. 이러한 합병증은 구치부보다 전치부에서, 연결한 보철물 보다 연결하지 않은 보철물에서, 가공선 클래스프를 유지장치로 이용한 보철물에서, 대합치가 의치를 포함하는 보철물보다 자연치열인 경우 합병증 발생이 좀 더 높은 빈도로 나타난 것을 확인 할 수 있었다. 케네디 분류에 따른 합병증 발생 빈도 차이는 유의한 차이를 확인할 수 없었다. 결론: 임플란트 융합 국소의치는 장기간 사용되고 있고 충분히 효과적으로 기능하고 있었다. 하지만 아직까지 이러한 치료의 예후에 대한 축적된 임상 결과는 많이 부족한 실정이므로 좀 더 장기적인 임상 연구가 필요한 상황이다.
Abstract
Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheseswere used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPDfor long-term result.
참고문헌 (28)
- Misch CE, "Contemporary implant dentistry" (2008), Elsevier
- Naert I, "A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture:prosthetic aspects and patient satisfaction", J Oral Rehabil, 26, pp.195~202 (1999)
- Thomason JM, "The McGill Consensus Statement on Overdentures. Mandibular 2-implant overdentures as first choice standard of care for edentulous patients", Eur J Prosthodont Restor Dent, 10, pp.95~96 (2002)
- Ohkubo C, "Effect of implant support on distal extension removable partial dentures: in vitro assessment", J Oral Rehabil, 34, pp.52~56 (2007)
- Kaufmann R, "Removable dentures with implant support in strategic positions followed for up to 8 years", Int J Prosthodont, 22, pp.233~241 (2009)
- Kuzmanovic DV, "Distal implants to modify the Kennedy classification of a removable partial denture: a clinical report", J Prosthet Dent, 92, pp.8~11 (2004)
- Mijiritsky E, "Use of dental implants to improve unfavorable removable partial denture design", Compend Contin Educ Dent, 26, pp.744~746 (2005)
- Schneid T, "Stewart's clinical removable partial prosthodontics", pp.259~277 (2008), Quintessence Publishing
- Kordatzis K, "Posterior mandibular residual ridge resorption in patients with conventional dentures and implant overdentures", Int J Oral Maxillofac Implants, 18, pp.447~452 (2003)
- Grossmann Y, "Clinical effectiveness of implantsupported removable partial dentures: a review of the literature and retrospective case evaluation", J Oral Maxillofac Surg, 67, pp.1941~1946 (2009)
- Lacerda TESP, "Contribution to the planning of implant-supported RPD in the distal region", RPG Rev Po′s Grad, 12, pp.293~300 (2005)
- Mijiritsky E, "Implants in conjunction with removable partial dentures:a literature review", Implant Dent, 16, pp.146~154 (2007)
- Ohkubo C, "Effect of implant support on distal-extension removable partial dentures: in vivo assessment", Int J Oral Maxillofac Implants, 23, pp.1095~1101 (2008)
- Park JM, "Consideration for the combination treatment of removable partial denture and implant", Implantol, 19, pp.104~111 (2015)
- Ancowitz S, "Esthetic removable partial dentures", Gen Dent, 52, pp.453~459 (2004)
- Mijiritsky E, "Removable partial denture design involving teeth and implants as an alternative to unsuccessful fixed implant therapy: a case report", Implant Dent, 13, pp.218~222 (2004)
- Vahidi F, "Complications associated with implant-retained removable prostheses", Dent Clin North Am, 59, pp.215~226 (2015)
- Mitrani R, "Posterior implants for distal extension removable prostheses: a retrospective study", Int J Periodontics Restorative Dent, 23, pp.353~359 (2003)
- Jang Y, "Single implant-supported crown used as an abutment for a removable cast partial denture: a case report", Implant Dent, 7, pp.199~204 (1998)
- Pellecchia M, "Distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis: a clinical report", J Prosthet Dent, 83, pp.607~612 (2000)
- Starr NL, "The distal extension case: an alternative restorative design for implant prosthetics", Int J Periodontics Restorative Dent, 21, pp.61~67 (2001)
- Chronopoulos V, "The use of dental implants in combination with removable partial dentures: a case report", J Esthet Restor Dent, 20, pp.355~364 (2008)
- Saito M, "Complications and failures in removable partial dentures: a clinical evaluation", J Oral Rehabil, 29, pp.627~633 (2002)
- Hakan Bilhan, "Complication rates and patient satisfaction with removable dentures", The Journal of Advanced of Prosthodontics, 4(2), pp.109~115 (2012), 대한치과보철학회[DOI]
- Goodacre CJ, "Clinical complications with implants and implant prostheses", J Prosthet Dent, 90, pp.121~132 (2003)
- Weinberg LA, "Lateral forces in relation to the denture base and clasp design", J Prosthet Dent, 6, pp.785~800 (1956)
- Stoumpis C, "To splint or not to splint oral implants in the implant-supported overdenture therapy? A systematic literature review", J Oral Rehabil, 38, pp.857~869 (2011)
- Miyaura K, "Rehabilitation of biting abilities in patients with different types of dental prostheses", J Oral Rehabil, 27, pp.1073~1076 (2000)