마모가 심한 환자에서 수직 고경 증가를 동반하여 수복한 증례
Full mouth rehabilitation in a severe worn dentition with vertical dimension gaining: A case report
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
교합의 점진적인 마모는 연령이 증가함에 따라 진행되는 정상적인 과정이다. 하지만 교합면의 마모가 과도하게 진행되어 수직 교합 고경이 감소하고 교합 평면이 붕괴된 경우에는 병적인 치수 상태, 교합 부조화, 기능적 장애 및 심미적인 문제가 나타날 수 있다. 치아를 수복할 공간이 부족하거나 교합 관계를 수정하기 위해서는 수직 교합 고경의 변경이 필요하다. 수직 고경을 변화시킬 경우, 수복 치료를 시작하기 전에 신중한 진단이 필수적이며 1 - 3개월 간 임시 수복물을 이용하여 근 신경계의 적응 범위를 벗어나지 않는지 평가를 한 후 최종 수복을 하여야 한다. 본 증례의 환자는 다수 치아들의 심한 마모가 있는 78세 남성 환자로서 수직 교합 고경의 평가 후 상악 전치부의 심미적인 외형 확보 및 교합관계, 교합평면의 개선을 위하여 최소한의 수직교합고경의 거상을 통하여 임시치아를 제작, 약 12주간의 적응기간 후 최종수복물을 제작하였다. 최종 수복물 장착 후 1년여의 경과 관찰 결과 새로 형성한 교합이 안정적으로 유지되었으며 특이할만한 합병증은 없었다. 이러한 일련의 치료과정을 통해 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.
Abstract
The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.
참고문헌 (21)
- Dawson PE, "Functional occlusion - From TMJ to smile design", pp.430~433 (2006), Mosby
- Murphy T, "Compensatory mechanisms in facial height adjustment to functional tooth attrition", Aust Dent J, 4, pp.312~323 (1959)
- Murphy TR, "The progressive reduction of tooth cusps as it occurs in natural attrition", Dent Fract Dent Rec, 19, pp.8~14 (1968)
- Turner KA, "Restoration of the extremely worn dentition", J Prosthet Dent, 52, pp.467~474 (1984)
- Silverman MM, "The speaking method in measuring vertical dimension. 1952", J Prosthet Dent, 85, pp.427~431 (2001)
- Silverman MM, "Determination of vertical dimension by phonetics", J Prosthet Dent, 6, pp.467~471 (1956)
- Williamson EH, "Cephalometric analysis: comparisons between maximum intercuspation and centric relation", Am J Orthod, 74, pp.672~677 (1978)
- Willis FM, "Features of the face involved in full denture prosthesis", Dent Cosmos, 77, pp.851~854 (1935)
- Bloom DR, "Increasing occlusal vertical dimension-why, when and how", Br Dent J, 200, pp.251~256 (2006)
- Abduo J, "Safety of increasing vertical dimension of occlusion:a systematic review", Quintessence Int, 43, pp.369~380 (2012)
- Rivera-Morales WC, "Relationship of occlusal vertical dimension to the health of the masticatory system", J Prosthet Dent, 65, pp.547~553 (1991)
- Abduo J, "Clinical considerations for increasing occlusal vertical dimension: a review", Aust Dent J, 57, pp.2~10 (2012)
- Carlsson GE, "Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth", J Prosthet Dent, 41, pp.284~289 (1979)
- Johansson A, "A cross-cultural study of occlusal tooth wear", Swed Dent J Suppl, 86, pp.1~59 (1992)
- Bindl A, "Thin-wall ceramic CAD", CAM crown copings: strength and fracture pattern, 2006, pp.33, 520~528
- Kim JH, "Fracture load of zirconia crowns according to the thickness and marginal design of coping", J Prosthet Dent, 108, pp.96~101 (2012)
- Park JH, "Antagonist wear of three CAD", CAM anatomic contour zirconia ceramics, 2014, pp.111, 20~29
- Yin L, "An overview of in vitro abrasive finishing & CAD", CAM of bioceramics in restorative dentistry, 2006, pp.46, 1013~1026
- Amer R, "Three-body wear potential of dental yttrium-stabilized zirconia ceramic after grinding, polishing, and glazing treatments", J Prosthet Dent, 112, pp.1151~1155 (2014)
- Mitov G, "Wear behavior of dental Y-TZP ceramic against natural enamel after different finishing procedures", Dent Mater, 28, pp.909~918 (2012)
- Sailer I, "Five-year clinical results of zirconia frameworks for posterior fixed partial dentures", Int J Prosthodont, 20, pp.383~388 (2007)