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Monolithic zirconia framework으로 제작된 fixed detachable prostheses를 이용한 심미적인 임플란트 전악 수복 증례

Esthetic Full Zirconia Fixed Detachable Implant-Retained Restorations Manufactured from Monolithic Zirconia : Clinical Report

조인호|한세진|최유성|홍준태
대한턱관절교합학회 (Korean academy of stomatognathic function and occlusion)|2012.09|구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)|제28권 제3호|pp. 253-268

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키워드

Dental implantFixed detachable restorationMonolithic zirconiaScrew-retained restorationZirconia frameworks
주제분류치의학

초록

수직적, 수평적 골흡수가 심한 환자에서 임플란트를 이용한 전악수복의 경우 경조직과 연조직 이식을 통해서 임플란트를 원하는 위치에 식립할 수도 있지만, 치은과 치아의 기능과 심미를 회복할 수 있는 fixed detachable prostheses를 대체 술식으로 사용할 수도 있다. 이러한 증례에서 다양한 재료가 수복물의 제작에 사용 가능하지만, metal/acrylic 보철물에서는 레진치아의 파절 및 탈락이 일어날 수 있고, metal/ceramic 혹은 zirconia/ceramic 보철물에서는 도재의 chipping이나 파절과 같은 문제가 발생할 수 있다. 이에 최근에 심미적이면서도 기능적인 보철수복을 위해 zirconia에 도재를 축성하지 않고 임상적으로 적용가능한 monolithic zirconia framework이 출시되어 사용되고 있다. 본 임상 증례는 심미적인 요구도가 높은 완전 무치악 환자에서 임플란트를 식립하고 chipping이나 파절의 위험을 감소시키기 위해 monolithic zirconia framework을 이용해 만들어진 complete fixed detachable 보철물을 이용한 수복에 대해 보고하고자 한다. 이번 증례에서 보철물은 심미적, 기능적으로 만족스러웠으며, 2년 간의 정기 검사에서 임상적인 합병증은 보고되지 않았다.

Abstract

Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

참고문헌 (43)

  1. Sjögren G, "Laser welding of titanium in dentistry", Acta Odontol Scand, 46, pp.247~253 (1988)
  2. Örtorp A, "Clinical experiences of laser welded titanium frameworks supported by implants in the edentulous mandible. A 5-year follow-up study", Int J Prosthodont, 12, pp.65~72 (1999)
  3. Bergendal, "Laser-welded titanium framework for implant-supported fixed prostheses: a 5-year report", Int J Oral Maxillofac Implants, 14, pp.69~71 (1999)
  4. Örtorp A, "Clinical experiences of computer numeric control-milled titanium frameworks supported by implants in the edentulous jaw: a 5-year prospective study", Clin Implant Dent Relat Res, 2, pp.2~9 (2000)
  5. Duncan JP, "Prosthodontic complications in a prospective clinical trial of single-stage implants at 36 months", Int J Oral Maxillofac Implants, 18, pp.561~565 (2003)
  6. Örtorp A, "Early laser-welded titanium frameworks supported by implants in the edentulous mandible: a 15-year comparative follow-up study", Clin Implant Dent Relat Res, 11, pp.311~322 (2009)
  7. Purcell BA, "Prosthetic complications in mandibular metal-resin implant-fixed complete dental prostheses: a 5-to 9-year analysis", Int J Oral Maxillofac Implants, 23, pp.847~857 (2008)
  8. Bozini T, "A meta-analysis of prosthodontics complication rates of implant- supported fixed dental prostheses in edentulous patients after an observation period of at least 5 years", Int J Oral Maxillofac Implants, 26, pp.304~318 (2011)
  9. Larsson C, "A prospective study of implant-supported full-arch yttria-stabilized tetragonal zirconia polycrystal mandibular fixed dental prostheses: three-year results", Int J Prosthodont, 23, pp.364~369 (2010)
  10. 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)
  11. Hassel AJ, "Rehabilitation of an edentulous mandible with an implant-supported fixed prosthesis using an all-ceramic framework: a case report", Quintessence Int, 39, pp.421~426 (2008)
  12. Linkevicius T, "Veneer fracture in implant-supported metal-ceramic restorations. Part I: Overall success rate and impact of occlusal guidance", Stomatologija, 10, pp.133~139 (2008)
  13. Roberts DH, "The failure of retainers in bridge prostheses. An analysis of 2,000 retainers", Br Dent J, 128, pp.117~124 (1970)
  14. Jacobi R, "Effect of abutment mobility, site, and angle of impact on retention of fixed partial dentures", J Prosthet Dent, 54, pp.178~183 (1985)
  15. Reuter JE, "Failures in full crown retained dental bridges", Br Dent J, 157, pp.61~63 (1984)
  16. Llobell A, "Fatigue life of porcelain repair systems", Int J Prosthodont, 5, pp.205~213 (1992)
  17. Guess PC, "Zirconia in fixed implant prosthodontics. Clin Implant Dent Relat Res", Epub ahead of print (2010)
  18. Swain MV, "Unstable cracking (chipping) of veneering porcelain on all-ceramic dental crowns and fixed partial dentures", Acta Biomater, 5, pp.1668~1677 (2009)
  19. Larsson C, "A prospective study of implant-supported full-arch yttria-stabilized tetragonal zirconia polycrystal mandibular fixed dental prostheses: three-year results", Int J Prosthodont, 23, pp.364~369 (2010)
  20. Ohlmann B, "Fracture -load values of all-ceramic cantilevered FPDs with different framework designs", Int J Prosthodont, 22, pp.49~52 (2009)
  21. Al-Amleh B, "Clinical trials in zirconia: a systematic review", J Oral Rehabil, 37, pp.641~652 (2010)
  22. Zitzmann NU, "Treatment plan for restoring the edentulous maxilla with implant- supported restorations: removable overdenture versus fixed partial denture design", J Prosthet Dent, 82, pp.188~196 (1999)
  23. Bidra AS, "A classification system of patients for esthetic fixed implant-supported prostheses in the edentulous maxilla", Compend Contin Educ Dent, 31, pp.366~374 (2010)
  24. Kelly JR, "Stabilized zirconia as a structural ceramic: an overview", Dent Mater, 24, pp.289~298 (2008)
  25. Chevalier J, "Ceramics for medical applications: A picture for the next 20 years", J Eur Ceramic Soc, 29, pp.1245~1255 (2009)
  26. Denry I, "State of the art of zirconia for dental applications", Dent Mater, 24, pp.299~307 (2008)
  27. Rimondini L, "Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study", Int J Oral Maxillofac Implants, 17, pp.793~798 (2002)
  28. Scarano A, "Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study", J Periodontol, 75, pp.292~296 (2004)
  29. 정유석, "A study on the in-vitro wear of the natural tooth structure by opposing zirconia or dental porcelain", The Journal of Advanced of Prosthodontics, 2(3), pp.111~115 (2010), 대한치과보철학회
  30. Lim JH, "The effect of various graft materials on the stability of implant and peri-implant tissue response in rabbit tibia", J Korean Acad Oral Maxillofac Implantol, 5, pp.41~64 (2001)
  31. Turrel AJ, "Clinical assessment of vertical dimension", J Prosthet Dent, 28, pp.238~246 (1972)
  32. Zarb GA, "Boucher’s Prosthodontic Treatment for Edentulous Patients", pp.218~229 (1997), Mosby
  33. Henry PJ, "An alternate method for the production of accurate cast and occlusal records in the osseointegrated implant rehabilitation", J Prosthet Dent, 58, pp.694~697 (1987)
  34. Yanase RT, "Current issue form. How do you test a cast framework for a full arch fixed implant supported prosthesis?", Int J Oral Maxillofac Implants, 9, pp.471~474 (1994)
  35. Tan KB, "Three- dimensional analysis of the casting accuracy of one piece, osseointegrated implant retained prostheses", Int J Prosthodont, 6, pp.346~363 (1993)
  36. Hollender L, "Radiographic evaluation of osseointegrated implants of the jaws. Experimental study of the influence of radiographic techniques on the measurement of the relation between implant and bone", Dentomaxillofac Radiol, 9, pp.91~95 (1980)
  37. Flemming GJ, "The in vitro failure of all ceramic crowns and the connector area of fixed partial dentures using bilayered ceramic specimens: the influence of core to dentin thickness ratio", Dent Mater, 22, pp.771~777 (2006)
  38. Tsumita M, "Effect of framework shape on the fracture strength of implant-supported all-ceramic fixed partial dentures in the molar region", J Prosthodont, 17, pp.274~285 (2008)
  39. Sailer I, "Five-year clinical results of zirconia frameworks for posterior fixed partial dentures", Int J Prosthodont, 20, pp.383~388 (2007)
  40. Keough BE, "A ten-unit all- ceramic anterior fixed partial denture using Y-TZP zirconia", Pract Proced Aesthet Dent, 18, pp.37~43 (2006)
  41. Beuer F, "In vitro performance of full-contour zirconia single crowns", Dent Mater, 28, pp.449~456 (2012)
  42. Alghazzawi TF, "Influence of low-temperature environmental exposure on the mechanical properties and structural stability of dental zirconia", J Prosthodont, 21, pp.363~369 (2012)
  43. Rojas-Vizcaya FJ, "Full zirconia fixed detachable implant-retained restorations manufactured from monolithic zirconia: clinical report after two years in service", J Prosthodont, 20, pp.570~576 (2011)

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