만성 치주염 환자에서 소수 잔존치와 임플란트를 이용한 전악 수복: 증례 보고
Full mouth rehabilitation with a few remaining teeth and implants for a patient with chronic periodontitis: a case report
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만성 치주염 환자 치료시 잔존치 발치 여부를 결정할 때 신중을 기해야 한다. 고정성 또는 가철성 국소의치 치료시 치주조건이 불량한 치아를 지대치로 사용하면 과부하로 조기실패가 우려되어 발치를 고려하지만, 임플란트 고정성 보철물의 경우 잔존치로 전달되는 기능하중을 감소시킬 수 있기 때문에 잔존치를 유지시키는 경우가 많다. 잔존치를 이용한 전악수복시 proprioceptive response를 보존할 수 있어 악간관계와 교합평면 결정시 도움이 될 뿐 아니라 환자의 보철물에 대한 적응이 쉽다. 본 증례의 환자는 치주질환에 의해 다수치 상실 및 대합치의 정출을 보였다. 동요도가 심해 예후가 좋지 않은 치아를 발거하고 소수 잔존치와 임플란트로 전악수복하여 적절한 기능적, 심미적 결과를 얻었다.
Abstract
Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients’ proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.
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