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라미네이트 치아형성 디자인에 관한 문헌고찰

Tooth preparation design of dental laminate veneer: a review article

고경호|허윤혁|박찬진|조리라|조은혜
대한턱관절교합학회 (Korean academy of stomatognathic function and occlusion)|2016.09|구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)|제32권 제3호|pp. 149-157|DOI http://dx.doi.org/10.14368/jdras.2016.32.3.149

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참고문헌

키워드

법랑질치아형성enamelcontact area라미네이트구개오목인접면laminatetooth preparationpalatal concavity
주제분류치의학

초록

성공적인 라미네이트 치료를 위해서는 치아형성 방법이 매우 중요하다. 법랑질에 국한된 보존적인 치아형성, 치태조절이 용이한 치은연선상(equigingival) 변연, 가능한 존재하는 접촉점의 유지 등의 조건이 일반적으로 알려져 있으나 구체적인 치아형성 디자인에 관하여는 논쟁의 여지가 존재한다. 생역학적으로 고려해볼 때, 다음과 같은 사항들이 추천된다. 절단면 피개는 심미적 요구와 전방유도의 재설정 필요 여부 측면에서 결정해야 하며, 법랑질 두께가 충분한 경우에는 구개측 연장을 하는 것이 좋으나 응력 집중이 큰 구개오목(palatal concavity)에 변연이 위치하는 것은 부적절하다. 인접면 연장은 증례에 따라 선택적으로 시행하며, 인접면에 레진수복물이 존재하는 경우에는 표면처리 후 레진 수복물을 절반 이상 피개하는 형태의 라미네이트로 수복한다. 변색이 심하지 않은 근관치료가 시행된 치아의 경우 라미네이트 수복을 고려해 볼 수 있으며, 이 때 섬유강화레진 포스트를 사용하는 것을 추천한다.

Abstract

Tooth preparation design is essential for successful laminate veneer treatment. Preservative tooth preparation limited on enamel, supra-margin advantageous for plaque control, and maintaining contact points known as a standard concept. However, the tooth preparation design has been the controversial issue. In biomechanical considerations, the incisal coverage should be decided on esthetic needs and necessity for the anterior guidance reconstruction. In occasion for sufficient enamel thickness, preparation can prolong to the palatal side but not recommended at palatal concavity. Elongation to contact point is selective option according to the cases. If an old resin restoration located at contact area, laminate veneer should cover over half area of that after surface treatment. The laminate veneer can be also selected at a partially discolored tooth root canal therapy (RCT) and at this occasion, the fiber-reinforced composite (FRC) posts are recommended.

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