체계적 분석, 진단, 치료 계획을 통한 전악 보철 재건 증례
Full mouth prosthetic rehabilitation based on systemic analysis, diagnosis and treatment plan: a case report
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
성공적인 보철 치료를 위해서는 정확한 진단이 근거가 되어야 한다. 즉, 처음 환자가 내원하였을 때, 환자의 주소를 바탕으로 한 문제점을 찾고, 그 원인을 분석하여 이에 입각한 치료 계획을 세웠을 때, 만족스러운 결과를 기대할 수 있을 것이다. 본 증례의 환자는 77세 여성으로, 저작 시 상, 하악 좌측 소구치 부위의 통증 및 기존 보철물의 비심미성을 주소로 내원하였다. 임상적, 방사선학적 검사 및 모형 분석을 통해 문제점을 파악하였고, 여러 문헌에 근거하여 지대치 평가, 보철물의 여러 가지 디자인에 따른 예후 및 최종 보철물의 장착 시 유지 관리의 용이성 등을 고려하여 치료 계획을 수립하기로 하였다. 심미적 문제, 보철을 위한 악간 공간의 부족을 해소하고자 최소한의 수직 고경 증가를 동반한 전악 수복을 시행하기로 결정하였다. 기능, 심미성 및 교합의 안정을 통한 환자의 적응도를 평가하여 치료 계획의 적절성 여부를 판단할 수 있었다. 따라서, 최종적인 고정성 국소 의치를 제작하고 장착하여 만족스러운 결과를 얻었기에 이를 보고하는 바이다.
Abstract
Data collection including checking the problem list and analyzing the etiology cannot be overemphasized in full mouth rehabilitation cases. It is well reported that favorable prognosis of prosthodontic treatment depends on accurate diagnosis. Seventy seven year old female patient presented with chief complaints of chewing pain on maxillary and mandibular left premolars and unesthetic existing prosthesis. Clinical evaluation, radiographic examination and cast analysis were performed to gather comprehensive data and problem lists. Treatment planning was based on collected data and related articles. Abutment evaluation, prognosis depending on various types of prosthesis, and maintenance were considered as well. Occlusal vertical dimension was increased to solve esthetic dissatisfaction and insufficient interocclusal space. Patient adaptation was verified with provisional restorations followed by diagnostic wax up. Function, esthetics and occlusal stability were verified during 8 week follow-up period. Prosthodontic reconstruction based on systemic analysis, diagnosis, and treatment plan led to satisfactory result after delivery of definitive prosthesis.
참고문헌 (16)
- Stockstill JW, "Clinical decision analysis in fixed prosthodontics", Dent Clin North Am, 36, pp.569~580 (1992)
- Fayz F, "Determination of occlusal vertical dimension: a literature review", J Prosthet Dent, 59, pp.321~323 (1988)
- Swerdlow H, "Vertical dimension literature review", J Prosthet Dent, 15, pp.241~247 (1965)
- Niswonger ME, "The rest position of the mandible and the centric relation", JADA, 21, pp.1572~1582 (1934)
- Niswonger ME, "Obtaining the vertical relation in edentulous cases that existed prior to extraction", JADA, 25, pp.1842~1847 (1938)
- Atwood DA, "A cephalometric study of the clinical rest position of the mandible: Part I. The variability of the clinical rest position following the removal of occlusal contacts", J Prosthet Dent, 6, pp.504~519 (1956)
- Hemmings KW, "Partial dentures for patients with advanced tooth wear", Dent Update, 22, pp.52~59 (1995)
- Ibbetson RJ, "Treatment of the worn dentition: 2", Dent Update, 16, pp.300~307 (1989)
- Turner KA, "Restoration of the extremely worn dentition", J Prosthet Dent, 52, pp.467~474 (1984)
- Jensen WO, "Occlusion for the Class II jaw relations patient", J Prosthet Dent, 64, pp.432~434 (1990)
- Hull CA, "A cephalometric approach to establishing the facial vertical dimension", J Prosthet Dent, 20, pp.37~42 (1968)
- Willis FM, "Features of the face involved in full denture prosthesis", Dent Cosmos, 77, pp.851~854 (1935)
- Grossmann Y, "The prosthodontic concept of crownto- root ratio: a review of the literature", J Prosthet Dent, 93, pp.559~562 (2005)
- Fayz F, "Use of anterior teeth measurements in determining occlusal vertical dimension", J Prosthet Dent, 58, pp.317~322 (1987)
- Avila G, "A novel decision-making process for tooth retention or extraction", J Periodontol, 80, pp.476~491 (2009)
- Shillingburg H, "Fundamentals of fixed prosthodontics", pp.100~102 (1997), Quintessence Publishing Co