구개부 치조골 결손을 보이는 상악 전치 상실부의 임플란트 심미보철수복: 증례보고
Esthetic implant restoration in the maxillary anterior missing area with palatal defect of the alveolar bone: a case report
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초록
치조골 폭이 협소한 상악 전치부의 심미적인 임플란트 수복은 임플란트 식립체의 경사각과 위치가 제한되기 때문에 단순한 임플란트 식립만으로는 심미적인 임플란트 보철물을 제작하기 어려운 일이다. 임플란트 보철물이 변연 치은과 조화로운 출현윤곽을 재현하기 위해서는 임플란트 식립체의 이상적인 치조골 내 위치와 식립각이 설정될 수 있어야 하며, 이를 위해서는 종종 임플란트 식립 전 골증대술을 선행하여야 한다. 본 증례는 구개측의 심한 골 결손을 동반한 얇은 치조골 폭을 보이는 상악 전치 상실부에 골증대술을 시행한 후, 임플란트를 식립하여 심미 보철을 시행한 증례이다. 먼저 협측에 과량의 골증대술을 선행하여 불리한 임플란트 식립 위치를 보상할 수 있는 구개측 식립 경사를 확보하였으며, 임시보철물의 외형을 조정하여 인접 치아와 조화로운 변연 치은 높이와 치간 유두를 형성하였다. 최종적으로 지르코니아 코어를 가지는 도재수복물을 이용하여 보철 수복하였고 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.
Abstract
It is challenging to produce esthetic implant restoration in the narrow anterior maxilla region where insufficient volume of alveolar bone could limit the angle and position of implant fixture, if preceding bone augmentation is not considered. Ideal angle and position of implant fixture placement should be established to reproduce harmonious emergence profile with marginal gingiva of implant prosthesis, bone augmentation considered to be preceded before implant placement occasionally. In this case, preceding bone augmentation has been operated before esthetic implant prosthesis in narrow anterior maxilla region. Preceded excessive bone augmentation in buccal area allowed proper angulation of implantation, which compensates unfavorable implant position. Provisional restorations were corrected during sufficient period to make harmonious level of marginal gingiva and interdental papilla. The definite restoration was fabricated using zirconia core based glass ceramic. Functionally and esthetically satisfactory results were obtained.
참고문헌 (18)
- Buser D, "Optimizing esthetics for implant restorations in the anterior maxilla:anatomic and surgical considerations", Int J Oral Maxillofac Implants, 19, pp.43~61 (2004)
- 서치원, "A technique for fabricating abutment replica with hot melt adhesive material to minimize residual cement in implant restoration: a case report", 구강회복응용과학지, 32(3), pp.240~245 (2016), 대한턱관절교합학회[DOI]
- Araújo MG, "Dimensional ridge alterations following tooth extraction. An experimental study in the dog", J Clin Periodontol, 32, pp.212~218 (2015)
- Malchiodi L, "Rigid fixation by means of titanium mesh in edentulous ridge expansion for horizontal ridge augmentation in the maxilla", Int J Oral Maxillofac Implants, 13, pp.701~705 (1998)
- von Arx T, "The TIME technique:a new method for localized alveolar ridge augmentation prior to placement of dental implants", Int J Oral Maxillofac Implants, 11, pp.387~394 (1996)
- von Arx T, "Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants", Clin Oral Implants Res, 10, pp.24~33 (1999)
- Phillips JH, "Fixation effects on membranous and endochondral onlay bone graft revascularization and bone deposition", Plast Reconstr Surg, 85, pp.891~897 (1990)
- Zins JE, "Membranous versus endochondral bone: implications for craniofacial reconstruction", Plast Reconstr Surg, 72, pp.778~785 (1983)
- Rabie AB, "Ultrastructural identification of cells involved in the healing of intramembraneous and endochondral bones", Int J Oral Maxillofac Surg, 25, pp.383~388 (1996)
- Roccuzzo M, "Vertical alveolar ridge augmentation by means of a titanium mesh and autogenous bone grafts", Clin Oral Implants Res, 15, pp.73~81 (2004)
- Lazzara RJ, "Managing the soft tissue margin: the key to implant aesthetics", Pract Periodontics Aesthet Dent, 5, pp.81~88 (1993)
- Hürzeler MB, "Advanced surgical and prosthetic management of the anterior single tooth osseointegrated implant: a case presentation", Pract Periodontics Aesthet Dent, 6, pp.13~21 (1994)
- Bichacho N, "A modified surgical", prosthetic approach for an optimal single implantsupported crown. Part II. The cervical contouring concept, 1994, pp.6, 35~41
- Grunder U, "Stability of the mucosal topography around single-tooth implants and adjacent teeth:1-year results", Int J Periodontics Restorative Dent, 20, pp.11~17 (2000)
- Small PN, "Gingival recession around implants: a 1-year longitudinal prospective study", Int J Oral Maxillofac Implants, 15, pp.527~532 (2000)
- Funato A, "Timing, positioning, and sequential staging in esthetic implant therapy: a four-dimensional perspective", Int J Periodontics Restorative Dent, 27, pp.313~323 (2007)
- Misch CE, "Contemporary implant dentistry", pp.739~768 (2009), CV Mosby
- Bengazi F, "Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study", Clin Oral Implants Res, 7, pp.303~310 (1996)