디지털 가이드를 이용한 상악 전치부 임플란트 즉시 식립 및 임시 수복을 통한 심미적 보철 수복 증례
Aesthetic prosthetic restoration through immediate implant placement and provisional restoration in the maxillary anterior region using a digital guide
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"상악 전치부의 즉시 임플란트 식립과 즉시 부하는 심미적 요구를 빠르게 개선할 수 있는 효과적인 방법이다. 이를 위해 임플란트 식립 시 골조직, 연조직 그리고 임플란트의 정확한 위치가 중요한 요건으로 제시된다. 성공적인 전치부 임플란트를 위해서는 골 증강, 임플란트 식립 위치의 정확성 그리고 필요 시 연조직 이식술을 고려해야 한다. 또한 임시 치아 수복을 통해 심미적 보철물의 외형과 연조직의 심미적 결과를 달성할 수 있다. 임시 치아의 연조직 몰딩(soft tissue molding)을 통해 출현윤곽(emergence profile)을 형성하고 이를 최종 보철물에 반영하여 심미적이고 기능적인 보철 수복을 완성할 수 있다. 이와 같은 접근법은 전치부의 심미적 결과를 최적화하고 임플란트 주변 연조직의 자연스러운 형태를 유지하는 데 기여한다. 본 증례의 경우 상악 전치부의 발치가 필요한 환자에서 CT 데이터를 이용하여 미리 제작한 가이드로 발치 후 임플란트의 즉시 식립 및 치조골 이식을 함께 진행하였으며, 당일 임시 보철물까지 장착하였다. 또한 임시 보철물에서부터 최종 보철물로의 단계적 이행으로 심미적이고 기능적인 전치부 임플란트 수복을 하였기에 이를 보고하고자한다."
Abstract
Immediate implant placement and immediate loading in the anterior maxilla is an effective approach to rapidly address aesthetic demands. To achieve successful outcomes, bone quality, soft tissue condition, and accurate implant positioning are essential factors. For optimal results, procedures such as bone augmentation, precise implant placement, and, when necessary, soft tissue grafting should be considered. Furthermore, provisional restoration play a crucial role in achieving the desired appearance of prosthetic restorations and improving the aesthetics of the soft tissue. By performing soft tissue molding through provisional restoration, an ideal emergence profile can be established, which can be subsequently transferred to the final prosthesis, leading to a functional and aesthetically pleasing restoration. This approach aims to optimize the aesthetic outcomes in the anterior region while preserving the natural contours of the peri-implant soft tissue. In this case, a patient requiring extraction of maxillary anterior tooth underwent immediate implantation and alveolar bone grafting using a guide fabricated in advance from CT data. The patient received a provisional restoration on the same day. Subsequent steps included transitioning from the provisional prosthesis to the definitive prosthesis, ultimately achieving an aesthetically pleasing and functional implant restoration. We report this case to highlight the successful approach to maxillary anterior implant rehabilitation.
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