DOI QR코드

DOI QR Code

무치악 환자에서 로케이터 부착장치를 이용한 임플란트 피개의치 수복 증례

Implant overdenture treatment using Locator attachment system on edentulous patient

  • 김수엽 (단국대학교 치과대학 치과보철학교실) ;
  • 신수연 (단국대학교 치과대학 치과보철학교실)
  • Kim, Soo-Yeop (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Shin, Soo-Yeon (Department of Prosthodontics, College of Dentistry, Dankook University)
  • 투고 : 2014.02.28
  • 심사 : 2014.05.01
  • 발행 : 2014.06.30

초록

심하게 흡수된 치조제는 기능적인 하중을 견디기 어렵고 구강 조직의 유해 변화와 더불어 환자의 의치 적응을 어렵게 한다. 환자의 불편감을 해소하고 의치의 안정성과 유지력을 증가시키기 위해 임플란트를 이용한 피개의치가 치료 방법으로 선택될 수 있다. 로케이터 부착장치는 사용상의 편리성이 높으며 다양한 유지력을 갖는 남자부를 보유함으로써 임상에서 볼 형태 부착장치대용으로 많이 사용되고 있다. 본 증례는 77세 여자환자로서 낮은 수직고경과 심한 치조제 흡수를 보이는 상하악 무치악 상태였다. 이에 하악에 4개의 임플란트를 식립하고, 상악은 총의치, 하악은 로케이터 부착장치를 이용한 임플란트 피개의치로 수복하여 기능 및 심미적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

Severely absorbed edentulous ridge cannot bear mechanical stress, causes undesired transformation of oral environment and makes patients difficult to adapt to dentures. Nowadays implant overdenture can be a treatment of choice in order to relieve patients' discomfort and improve stability and retention of the denture. Placement of implant on maxilla is difficult because of its bone quality and anatomic structure. It also has wide supportive tissue and convenience of border sealing, which provides sufficient support and stabilization with conventional complete denture. Mandible, on the other hand, is difficult to obtain sufficient support, retention and stabilization with conventional complete denture. Therefore, implant overdenture is recommended on mandible. Locator attachment has been improved for convenience of use and male parts of various retention enabled it to replace ball type attachment clinically. In this study, we restored maxillary arch with conventional denture, and mandibular arch with implant and tissue-supported overdenture and Locator attachment system.

키워드

참고문헌

  1. Rissin L, House JE, Manly RS, Kapur KK. Clinical comparison of masticatory performance and electromyographic activity of patients with complete dentures, overdentures, and natural teeth. J Prosthet Dent 1978;39:508-11. https://doi.org/10.1016/S0022-3913(78)80181-4
  2. Kapur KK, Soman SD. Masticatory performance and efficiency in denture wearers. 1964. J Prosthet Dent 2006;95:407-11. https://doi.org/10.1016/j.prosdent.2006.03.012
  3. Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, Head T, Lund JP, MacEntee M, Mericske-Stern R, Mojon P, Morais J, Naert I, Payne AG, Penrod J, Stoker GT Jr, Tawse-Smith A, Taylor TD, Thomason JM, Thomson WM, Wismeijer D. The McGill consensus statement on overdentures. Montreal, Quebec, Canada. May 24-25, 2002. Int J Prosthodont 2002;15:413-4.
  4. Närhi TO, Geertman ME, Hevinga M, Abdo H, Kalk W. Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures. J Prosthet Dent 2000;84:43-9. https://doi.org/10.1067/mpr.2000.107113
  5. Sadowsky SJ, Caputo AA. Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures. J Prosthet Dent 2000;84:327-34. https://doi.org/10.1067/mpr.2000.109378
  6. Davidoff SR, Steinberg MA, Halperin A. The implant-supported overdenture: a practical implantprosthetic design. Compendium 1993;14:722, 724-30.
  7. Mericske-Stern R, Zarb GA. Overdenture: an alternative implant methodology for edentulous patients. Int J Prosthodont 1993;6:203-8.
  8. Desjardins RP. Tissue-integrated prostheses for edentulous patients with normal and abnormal jaw relationships. J Prosthet Dent 1988;59:180-7. https://doi.org/10.1016/0022-3913(88)90013-3
  9. Heckmann SM, Winter W, Meyer M, Weber HP, Wichmann MG. Overdenture attachment selection and the loading of implant and denture-bearing area. Part 2: a methodical study using five types of attachment. Clin Oral Implants Res 2001;12:640-7. https://doi.org/10.1034/j.1600-0501.2001.120613.x
  10. Maxson BB, Powers MP, Scott RF. Prosthodontic considerations for the transmandibular implant. J Prosthet Dent 1990;63:554-8. https://doi.org/10.1016/0022-3913(90)90075-N
  11. Barber HD, Scott RF, Maxon BB, Fonseca RJ. Evaluation of anterior maxillary alveolar ridge resorption when opposed by the transmandibular implant. J Oral Maxillofac Surg 1990;48:1283-7. https://doi.org/10.1016/0278-2391(90)90483-I
  12. Thiel CP, Evans DB, Burnett RR. Combination syndrome associated with a mandibular implantsupported overdenture: a clinical report. J Prosthet Dent 1996;75:107-13. https://doi.org/10.1016/S0022-3913(96)90084-0
  13. Gotfredsen K, Holm B. Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study. Int J Prosthodont 2000;13:125-30.
  14. Bakke M, Holm B, Gotfredsen K. Masticatory function and patient satisfaction with implant supported mandibular overdentures: a prospective 5-year study. Int J Prosthodont 2002;15:575-81.
  15. Schneider AL, Kurtzman GM. Bar overdentures utilizing the Locator attachment. Gen Dent 2001;49:210-4.