심한 치주질환을 가진 환자에서 computer aided flapless surgery와 즉시부하를 통한 전악 구강 회복 증례
Full mouth rehabilitation of a patient with severe periodontitis using immediate loading after computer aided flapless implant surgery
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
치조골의 흡수와 치주조직의 염증을 동반한 심한 치주질환 환자에서 임플란트를 통한 구강 회복은 임상적으로 어려움이 있다. 하지만 골 형태에 따른 적절한 임플란트 식립 위치를 선정한다면 불필요한 골 이식이나 연조직 수술을 최소로 할 수 있다. 최근에는 cone beam CT 촬영과 소프트웨어를 이용하여 환자의 해부학적 형태와 보철적인 위치를 고려하여 임플란트 식립 위치를 선정할 수 있게 되었고 3D printing 기술을 통해 제작된 surgical guide를 통해 계획된 위치로 정확한 수술이 가능하게 되었다. 본 증례는 70세 여성 환자로 심한 치주질환으로 인해 전악 치아의 발치가 필요하였으며 임플란트 지지 고정성 보철물로 전악 구강회복을 시행하였다. 수술 시에는 보철적인 위치를 고려한 surgical guide를 이용해 flapless 방식으로 임플란트를 식립하였고 수술 전에 CAD/CAM 방식으로 제작된 임시보철물을 즉시 부하하였다. 이후 맞춤형 지대주와 지르코니아를 이용한 보철물을 제작하였으며, 만족스러운 심미 및 기능 회복을 보였기에 보고하는 바이다.
Abstract
Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant -supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.
참고문헌 (17)
- Mankoo T, "Rehabilitation of esthetics in advanced periodontal cases using orthodontics for vertical hard and soft tissue regeneration prior to implants - a report of 2 challenging cases treated with an interdisciplinary approach", Eur J Esthet Dent, 6, pp.376~404 (2011)
- Chiapasco M, "Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants", Clin Oral Implants Res, 17(Suppl 2), pp.136~159 (2006)[DOI]
- 2.0.CO;2,
- Jung RE, "Computer technology applications in surgical implant dentistry: a systematic review", Int J Oral Maxillofac Implants, 24(Suppl), pp.92~109 (2009)
- Hartlev J, "Immediate placement and provisionalization of single-tooth implants involving a definitive individual abutment: a clinical and radiographic retrospective study", Clin Oral Implants Res, 24, pp.652~658 (2013)[DOI]
- Schropp L, "Timing of implant placement relative to tooth extraction", J Oral Rehabil, 35(Suppl 1), pp.33~43 (2008)[DOI]
- Esposito MA, "Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate-delayed and delayed implants)", Cochrane Database Syst Rev, 4 (2006)
- Fortin T, "Effect of flapless surgery on pain experienced in implant placement using an image-guided system", Int J Oral Maxillofac Implants, 21, pp.298~304 (2006)
- Nkenke E, "Patient-centered outcomes comparing transmucosal implant placement with an open approach in the maxilla: a prospective, non-randomized pilot study", Clin Oral Implants Res, 18, pp.197~203 (2007)[DOI]
- Robling AG, "Mechanical signaling for bone modeling and remodeling", Crit Rev Eukaryot Gene Expr, 19, pp.319~338 (2009)[DOI]
- Arisan V, "Implant positioning errors in freehand and computer-aided placement methods: a single-blind clinical comparative study", Int J Oral Maxillofac Implants, 28, pp.190~204 (2013)[DOI]
- D'haese J, "Accuracy and complications using computer-designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature", Clin Implant Dent Relat Res, 14, pp.321~335 (2012)
- Ozan O, "Clinical accuracy of 3 different types of computed tomography-derived stereolithographic surgical guides in implant placement", J Oral Maxillofacial Surg, 67, pp.394~401 (2009)[DOI]
- Di Giacomo GA, "Clinical application of stereolithographic surgical guides for implant placement: preliminary results", J Periodontol, 76, pp.503~507 (2005)[DOI]
- Papaspyridakos P, "Complete arch implant rehabilitation using subtractive rapid prototyping and porcelain fused to zirconia prosthesis: a clinical report", J Prosthet Dent, 100, pp.165~172 (2008)
- Kanat B, "Effect of various veneering techniques on mechanical strength of computer-controlled zirconia framework designs", J Prosthodont, 23, pp.445~455 (2014)
- Heintze SD, "Survival of zirconia- and metal-supported fixed dental prostheses: a systematic review", Int J Prosthodont, 23, pp.493~502 (2010)