전치부 개방교합을 보이는 법랑질형성부전증 환자의 CAD/CAM system을 이용한 전악 수복 증례
Full-mouth rehabilitation in an amelogenesis imperfecta patient with anterior open bite using CAD/CAM system
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초록
법랑질 형성 부전증은 유전적인 결함으로 인해 구조적으로 약한 법랑질이 형성되는 질환이다. 이들 환자들은 이른 나이부터 진행되는 법랑질 마모에 의한 시린 증상과 비심미적인 치아를 주소로 치과에 내원하게 되며, 성장기 이후에는 전악 보철 수복을 통해 치아의 기능성과 심미성을 회복해 주게 된다. 법랑질 형성 부전증 환자에서 보여지는 전치부 개방 교합은, 구치의 교합면 마모 및 보상성 맹출에 의한 수직적 수복 공간 문제와 결부되어 보철 치료를 어렵게 하는 요인이 된다. 따라서 전치 길이의 결정 및 교합 고경의 거상 여부, 전방유도의 설정은 신중히 결정되어야 한다. 근래에는 Computer aided design-computer aided manufacturing (CAD/CAM) 기술을 이용하여 진단 및 최종 수복으로의 이행이 용이해 졌다. 본 증례에서는 전치부 개방교합을 가지고 있는 법랑질 형성 부전증 환자에서, CAD/CAM을 이용한 전악 수복을 시행한 후, 양호한 경과를 보이고 있기에 이를 보고하고자 한다.
Abstract
Amelogenesis imperfecta characterized as abnormally formed enamel is caused by a defect of unique group of genes. Patients affected by this disease might have difficulties in social and psychological aspects due to non-esthetic teeth as well as functional problems caused by enamel detachment and tooth wear from their early ages. Adult patients with amelogenesis imperfecta can be treated with full-mouth restorations, which make functional and esthetic rehabilitations of severely worn tooth. However, the anterior open bite and lack of occlusal clearance for posterior teeth restorations due to compensatory extrusion are the intervening factors in the prosthetic treatment. Therefore, the determination of anterior tooth lengths, vertical dimension, and anterior guidance should be set carefully. Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques help systematic approaches and enable dentists to reduce time-consuming procedures in the diagnosis and treatment of full-mouth rehabilitation. This case report demonstrates the successful full mouth rehabilitation using a CAD/CAM system in a young adult patient with amelogenesis imperfecta and anterior open bite.
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