과도한 치아 마모와 과개교합을 보이는 환자에서 최소한의 수직고경 증가를 동반한 전악 구강 회복 증례
Full-mouth rehabilitation with increasing minimum vertical dimension in the patient with severely worn dentition and deep bite
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심하게 마모된 치아를 가진 환자에서 수직교합고경 거상을 동반한 전악 보철수복이 계획 될 수 있다. 하지만 치아가 심하게 마모되더라도 치조돌기가 보상 성장하여 환자의 수직 고경은 변하지 않을 수 있다. 이런 경우 수복 공간 확보를 위해서 수직고경을 변화시켜야 한다면 심미적이고 기능적인 목표를 만족하는 최소한의 수직교합고경 거상을 선택해야 한다. 본 증례에서 환자는 전반적인 치아 마모로 저작 시 어려움을 호소하였고, 마모가 심한 하악 전치부의 심미적 개선을 원하였다. 수직고경 감소의 평가 및 적절한 수직고경 결정을 위해 안모 계측, 임상적 치관 길이 평가, 교합안정공극 측정, 측방 두부계측방사선사진 분석 등을 시행하였고, 체계적인 진단과 평가를 거쳐 보철 수복 공간 확보를 위해 최소한의 수직고경 거상을 동반한 전악 구강회복술을 시행하였다. 중심위에서 안정적인 교합 접촉 및 조화로운 전방, 측방 유도 부여를 통해 환자의 기능적, 심미적 문제를 해결할 수 있었다.
Abstract
Full-mouth rehabilitation with increasing vertical dimension can be used for patients with severely worn teeth. In severely worn teeth also, the alveolar process can be elongated to compensate for the reduced vertical dimension, and the patient’s vertical dimension of occlusion can be kept constant. However, full-mouth rehabilitation with increasing vertical dimension must be carefully chosen, because the vertical dimension can be reduced by tooth wear. It is important to establish a treatment plan with the systematic diagnosis of the change in the vertical dimension and gain space for the prosthesis. It is necessary to change the vertical dimension to secure the restoration space and select the minimum vertical dimension elevation for the esthetic and functional goal. In this case report, the patient complained of difficulty during chewing due to a worn dentition and wanted esthetic improvement of the short mandibular anterior teeth. After systematic evaluation and diagnosis, we performed full-mouth rehabilitation with minimum vertical dimension elevation to obtain the space for restoration. This resulted in a stable and harmonious occlusion, and the functional and esthetic problems of the patient were solved after treatment. The patient was satisfied with the results of the treatment and maintained stable occlusion during the follow-up period.
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