성장 장애를 가진 부분 무치악 환자에서 위축된 골에 무피판 임플란트 수술 증례
Flapless implant surgery on atrophied alveolar ridge in a patient with growth disorder
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성장장애는 두개안면부의 골격성장과 영구치의 조기상실에 영향을 미친다. 본 증례는 성장장애 환자에서 치아를 조기 상실한 부위에 무피판 술식으로 임플란트를 식립 시 컴퓨터 단층촬영(CT)을 통한 인접치아의 확인과 임플란트 가이드의 필요성을 살펴보았다. 특발성 저신장과 3급 정신지체의 20세의 여환에서 구치의 회복을 위해 임플란트 고정성 보철을 계획하였다. CT 영상에서 인접치가 심하게 협측으로 위치되어 있었고, 이를 반영하여 가이드를 제작후 임플란트를 식립하였다. 이상 위치된 인접치를 기준으로 임플란트를 식립할 경우 협측 골의 천공이 발생할 수 있다. 그러므로 성장장애 환자에서 치아 조기 상실부에 임플란트를 식립 시 CT를 통한 치아의 위치 확인과 가이드의 제작이 요구된다.
Abstract
The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.
참고문헌 (20)
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