하악 전치부 상실로 인한 조음장애를 보이는 경도 지적장애 환아에서탄성의치를 통한 조음능력의 향상
Improvement of Articulation Disorder Using Flexible Partial Denture in Intellectural Disability Patient with Missing Lower Incisors
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초록
구강악안면의 여러 구조는 매우 복잡하고 정밀한 상호과정을 거쳐 말소리를 만들어낸다. 그 중 치아는 중요한 조음기관으로서 치아의 상실시 정상적인 발음을 하기 위해서는 혀와 턱의 위치 수정을 통한 적응이 필요하며, 적응 가능 범위를 벗어난경우에는 적극적인 보철적, 교정적 치료를 요하게 된다. 소아의 다수 치아 상실은 조음에 어려움을 가져올 뿐만 아니라 부정교합, 악골발육 저하, 측두하악관절의 변위, 저작력 저하, 영양 불균형, 심미성 저하 등의 문제를 초래하기 때문에 반드시 상실부위의 회복이 필요하다. 아크릴릭 레진을 이용한 기존의 가철성 장치와 비교하여 Valplast 탄성의치는 조직과 긴밀하기접착되며 치은의 자연적인 색조를 투과시키는 얇고 강한 레진 유지부를 가져 심미성이 매우 높으며 우수한 물성을 가지는 등많은 장점을 갖고 있다.특히 전체적인 두께가 얇고 부피가 작아 이물감이 적고 혀의 움직임을 방해하지 않기 때문에 발음의회복에 장점을 가진다. 본 증례는 완전탈구된 하악 전치부로 인해 조음장애를 보였으나 Valplast 탄성의치를 장착한 후 조음의 개선을 보인 경도 지적장애 환아에 관한 것으로 조음검사를 통해 하악 전치부의 상실이 조음에 미치는 영향에 보고하고자 한다.
Abstract
Speech is complex psycho-physiological mutual process which includes many orofacial organs. Especially, teeth play an especially important role as an articulation organ in conjunction with the lips and tongue. When teeth are missing, the position of tongue and mandible is adjusted to produce correct sound. If a patient’s adaptive function is inadequate for modification of malocclusion, prosthodontic and orthodontic interventions are necessary. Missing teeth of young patients should be reconstructed bacause it can cause malocclusion, decreased masticatory efficiency, articulation disorders, esthetic problem, and temporomandibular disorder. Valplast(Valplast International Corp, New York, USA) flexible denture is useful for rehabilitation due to its excellent physical properties, esthetics, and small volume. This case is regardingan intellecturally disabled patient with anarticulation disorder caused by missing lower incisors due to trauma. The patient showed improvement in articulation by using flexible partial denture. The purpose of this report is to figure out the influence of missing lower anterior teeth on articulation.
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