광범위한 치질 상실로 인해 수직 고경 감소 환자의 전악 수복 증례
Full mouth rehabilitation in a patient with loss of vertical dimension caused by severe tooth loss: a case report
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초록
광범위한 치아 상실과 마모로 인한 교합면의 파괴로 수직고경이 감소된 경우 안모의 변화, 전방 유도의 상실로 인한 반대 교합을 보일 수 있으며, 또한 턱관절의 문제를 발생 시킬 수도 있다. 이러한 경우 교합 수직 고경의 증가를 통한 전악 수복을 고려할 수 있으며, 적절한 환자의 수직 고경 평가가 필요하다. 본 증례는 80세의 남자 환자로 전반적인 보철계획을 주소로 내원하였으며, 치아상실 및 마모에 따른 전치부의 반대 교합과 교합 수직 고경의 감소가 관찰되었다. 진단 모형과 방사선 사진, 임상적 검사를이용하여 교합 관계를 분석하여 교합 수직 고경 증가를 결정하였다. 진단 wax up을 시행하였고 임시 보철물을 제작하였다. 3개월의 적응 기간 후 상악 고정성 보철물과 하악 임플란트 지지 피개의치로 최종 수복하였다. 장착 후 8개월 경과 관찰 중이며 양호한 심미적 기능적 개선을 보였다.
Abstract
Decrease of occlusal vertical dimension (OVD) due to loss of teeth structure and destruction of the occlusal plane by severely worn dentition may cause cross bite or temporomandibular joint disorder by following change of facial feature or the loss of anterior guidance. Full mouth rehabilitation via an increase of the OVD can be considered to avoid this problem and proper evaluation of patient's OVD is essential. An 80 year old male visited for overall prosthodontic treatment, cross bite due to continuous wear and following decrease of the OVD were observed. We analyzed the existing occlusal relationship using the diagnostic cast, the radiographic evaluation and clinical test, and then proper increase of OVD was selected. The new OVD on diagnostic wax up was placed by the temporary restoration. After 3 months of observation period, final restoration with fixed partial dentures and implant overdenture were made. Throughout the follow-up period of 8 months, the aesthetic and functional improvement can be obtained.
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