고정성 보철물과 연관된 합병증과 실패에 관한 조사
Complication and Failure Analysis of Fixed Restorations
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고정성 보철물의 장기적 예후를 보장하고자 하는 많은 노력에도 불구하고, 아직도 임상에서는 부적절한 제작 및 유지 관리로 인한 다양한 고정성 보철물의 합병증이 관찰되고 있다. 이에 본 연구에서는 고정성 보철물의 임상적 상태를 조사하여 보철 진료의 임상적 참고 자료와 연구의 기초 자료로 도움이 되고자하였다. 2009년 1월에서 2009년 12월까지 12개월간 부산대학교병원 치과 보철과에 내원한 환자 중 기존의 고정성 보철물을 철거하고 치료를 시행한 환자를 대상으로 고정성 보철물과 지대치에 연관된 임상적 상태를 조사 평가하여 다음과 같은 결과를 얻었다. 1. 전체 고정성 보철물의 추정 수명은 10.0년이었고, 평균 장착 기간은 10.3±5.5년이었다. 2. 악골에 따른 수명의 차이는 없었으나 (P>.05), 전후방 위치에서는 전치부 또는 구치부에 비해 전치부와 구치부를 포함하는 보철물의 수명이 가장 길었다 (P<.05). 3. 고정성 보철물의 재료별 수명은 금속관이 가장 길었고 (P<.05), 다른 재료들 간에는 유의한 차이가 없었다 (P>.05). 4. 고정성 보철물의 크기는 보철물 수명에 영향을 미치지 않았다 (P>.05). 5. 대합치 조건별 고정성 보철물의 수명은 자연치와 고정성 보철물, 가철성 국소 의치, 총의치 순으로 길었다 (P<.05). 6. 고정성 보철물의 생물학적 합병증은 치주 질환 (37.5%), 치아 우식증 (19.0%), 그리고 치수 질환 (10.8%) 순이었고, 기계적 문제점은 변연 결함 (18.4%), 보철물 파절(4.2%), 유지력 상실 (3.9%), 치아 파절 (3.6%), 그리고 식편 압입 (2.6%) 순이었다. 보철물을 철거한 후 치대치의 33.1%는 재수복이 불가능한 상태였다.
Abstract
Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complication of fixed prostheses was found in the mouth of patient. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 154 individuals (aged 22-82, 88 women and 66 men loaded with 578 unit of fixed prostheses, and 423 abutments) who visited the Department of Prosthodontics, Pusan National University Hospital, between January 2009 to December 2009 and removed old fixed prostheses were examined. The results of this study were as follows:1. Length of service of fixed prostheses was 10.3±05.5 years (mean), 10.0 years (median). 2. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longeivity of fixed prostheses was high in anterio-posterior combination region (mean:13.1, median:13.5) than anterior and posterior region. 3. Longevity of fixed prostheses made of metal was longest (mean:13.3, median:12.3). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 5. Condition of opposing dentition was found to have statistically significant influence on longevity of fixed prostheses (P>.05). The fixed prostheses lasted longest when opposed by compolete denture (mean:17.1, median:19.7), removable partial denture, fixed prosthesis and natural dentition trailing behind (P<.05)6. Periodontal disease (37.5%), dental caries (19.0%), defective margin (18.4%) were frequent complications. In 33.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.
참고문헌 (23)
- Schwartz NL, "Unserviceable crowns and fixed partial dentures: life-span and causes for loss of serviceability", J Am Dent Assoc, 81, pp.1395~1401 (1970)
- Walton JN, "A survey of crown and fixed partial denture failures: length of service and reasons for replacement", J Prosthet Dent, 56, pp.416~421 (1986)
- Valderhaug J. A, "15-year clinical evaluation of fixed prosthodontics", Acta Odontol Scand, 49, pp.35~40 (1991)
- Palmqvist S, "Artificial crowns and fixed partial dentures 18 to 23 years after placement", Int J Prosthodont, 6, pp.279~285 (1993)
- Karlsson S, "A clinical evaluation of fixed bridges, 10 years following insertion", J Oral Rehabil, 13, pp.423~432 (1986)
- Glantz P-OJ, "Quality of extensive fixed prosthodontics after five years", J Prosthet Dent, 52, pp.475~479 (1984)
- Glantz P-OJ, "Sundberg H. Quality of fixed prosthodontics after 15 years", Acta Odontol Scand, 51, pp.247~252 (1993)
- Glantz P-OJ, "Quality of fixed prosthodontics after twenty-two years", Acta Odontol Scand, 60, pp.213~218 (2002)
- Moon HY, "A study on the life expectation of dental restorations", Korean academy of oral health, 9, pp.51~74 (1985)
- 신우진, "LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA", 대한치과보철학회지, 43(2), pp.158~175 (2005), 대한치과보철학회
- Foster LV, "The relationship between failure and design in conventional bridgework from general dental practice", J Oral Rehabil, 18, pp.491~495 (1991)
- Foster LV, "Failed conventional bridge work from general dental practice: clinical aspects and treatment needs of 142 cases", Br Dent J, 168, pp.199~201 (1990)
- Roberts DH, "The relationship between age and the failure rate of bridge prostheses", Br Dent J, 17, pp.175~177 (1970)
- Libby G, "Longevity of fixed partial dentures", J Prosthet Dent, 78, pp.127~131 (1997)
- Holm C, "Longevity and quality of FPDs: a retrospective study of restorations 30, 20, and 10 years after insertion", Int J Prosthodont, 16, pp.283~289 (2003)
- Drake CW, "Reasons for restoration replacement: differences in practice patterns", Quintessence Int, 21, pp.125~130 (1990)
- Ryge G, "Evaluating the clinical quality of restorations", J Am Dent Assoc, 87, pp.369~377 (1973)
- Leempoel PJB, "Survival studies of dental restorations: criteria, methods and analyses", J Oral Rehabil, 16, pp.387~394 (1989)
- Rudd KD, "Horizontal tooth mobility in carefully screened subgects", Periodontics, 2, pp.65~68 (1964)
- Reuter JE, "Failure in full crown retained dental bridges", Br Dent J, 157, pp.61~63 (1984)
- Randow K, "Technical failures and some related clinical complications in extensive fixed prosthodontics. An epidemiological study of long-term clinical quality", Acta Odontol Scand, 44, pp.241~255 (1986)
- Richter WA, "Relationship of crown margin placement to gingival inflammation", J Prosthet Dent, 30, pp.156~161 (1973)
- Hämmerle C, "Success and failure of fixed bridgework", Periodontology 2000, 4, pp.41~51 (1994)