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마모된 치열을 지닌 고령 환자의 상악 전악 고정성 수복 증례

Maxillary full-arch fixed dental prosthesis of the elderly patient with worn dentition

  • 이재현 (고려대학교 안암병원 치과 보철학교실) ;
  • 최연조 (고려대학교 안암병원 치과 보철학교실) ;
  • 류재준 (고려대학교 안암병원 치과 보철학교실)
  • Lee, Jae hyun (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center) ;
  • Choi, Yeon jo (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center) ;
  • Ryu, Jae jun (Division of Prosthodontics, Department of Dentistry, Anam Hospital, Korea University Medical Center)
  • 투고 : 2017.02.17
  • 심사 : 2017.04.10
  • 발행 : 2017.06.30

초록

노인 환자 구강의 생리적 변화 중 하나인 생리적 치아 마모는 일반적으로 치료를 필요로 하지 않으나 교합 부조화, 저작기능의 저하, 치수 노출 등 구강 내 문제 발생 시 보철 수복을 필요로 한다. 마모된 치열을 지닌 환자의 보철 수복 시 우선적으로 고려되는 사항들 중 하나가 바로 수직고경에 대한 고려이다. 이에 정확한 진단 및 분석과 예지성 있는 치료계획을 위한 악간관계에 대한 올바른 판단이 요구되며, 노인 환자의 치과 치료를 감안한 단계별 치료접근을 필요로 한다. 본 증례는 93세 남자 환자로 전반적인 치아 마모 및 기존 고정성 보철물의 동요도를 보이고 있었다. 진단 및 평가 후 수직교합 고경을 유지한 상악 구강회복술을 시행하였으며, 기능 및 형태적으로 만족할만한 결과를 보여 보고하는 바이다.

Tooth wear, one of the physiological changes in the elderly patient's mouth, generally does not require treatment, but requires prosthodontic restoration when occlusal disharmony, poor masticatory function, pulp exposure occurs. One of the primary considerations in prosthodontic restoration for tooth wear is vertical dimension. It is necessary to make an accurate diagnosis and analysis, correct judgement of the interdental relationship for predictive treatment plan. A step-by-step approach considering dental care for aged is also required. In this case, a 93-year-old male patient presented with worn dentition and mobility of existing fixed dental prosthesis. After diagnosis and evaluation, maxillary rehabilitation without any change in the occlusal vertical dimension was performed and this shows satisfactory results both functionally and morphologically.

키워드

참고문헌

  1. Donachie MA, Walls AW. Assessment of tooth wear in an ageing population. J Dent 1995;23:157-64. https://doi.org/10.1016/0300-5712(95)93573-K
  2. Dawson PE. Functional occlusion: from TMJ to smile design. St. Louis; Mosby; 2007. p. 430-52.
  3. Ramfjord SP, Blankenship JR. Increased occlusal vertical dimension in adult monkeys. J Prosthet Dent 1981;45:74-83. https://doi.org/10.1016/0022-3913(81)90015-9
  4. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1984;52:467-74. https://doi.org/10.1016/0022-3913(84)90326-3
  5. Lloyd PM. Fixed prosthodontics and esthetic considerations for the elder adult. J Prosthet Dent 1994;72:525-31. https://doi.org/10.1016/0022-3913(94)90126-0
  6. Willis FM. Features of the face involved in full denture prosthesis. Dent Cosmos 1935;77:851-4.
  7. Park JH, Jeong CM, Jeon YC, Lim JS. A study on the occlusal plane and the vertical dimension in Korean adults with natural dentition. J Korean Acad Prosthodont 2005;43:41-51.
  8. McAdam DB. Tooth loading and cuspal guidance in canine and group-function occlusions. J Prosthet Dent 1976;35:283-90. https://doi.org/10.1016/0022-3913(76)90252-3
  9. Luke DA, Lucas PW. The significance of cusps. J Oral Rehabil 1983;10:197-206. https://doi.org/10.1111/j.1365-2842.1983.tb00113.x
  10. Ingle JI. Alveolar osteoporosis and pulpal death associated with compulsive bruxism. Oral Surg Oral Med Oral Pathol 1960;13:1371-81. https://doi.org/10.1016/0030-4220(60)90302-9
  11. Jepson N, Allen F, Moynihan P, Kelly P, Thomason M. Patient satisfaction following restoration of shortened mandibular dental arches in a randomized controlled trial. Int J Prosthodont 2003;16:409-14.
  12. Mojon P, Rentsch A, Budtz-Jorgensen E. Relationship between prosthodontics status, caries, and periodontal disease in a geriatric population. Int J Prosthodont 1995;8:564-71.
  13. Budtz-Jorgensen E, Isidor F. A 5-year longitudinal study of cantilevered fixed partial dentures compared with removable partial dentures in a geriatric population. J Prosthet Dent 1990;64:42-7. https://doi.org/10.1016/0022-3913(90)90151-2
  14. Heschl A, Haas M, Haas J, Payer M, Wegscheider W, Polansky R. Maxillary rehabilitation of periodontally compromised patients with extensive onepiece fixed prostheses supported by natural teeth: a retrospective longitudinal study. Clin Oral Investig 2013;17:45-53.
  15. Gordon SR, Lloyd PM. Fixed prosthodontics in the elderly population. Life expectancy of fixed restorations, failures, and retreatment methods. Dent Clin North Am 1992;36:783-95.
  16. Shillingburg HT, Sather DA, Wilson EL, Cain JR, Mitchell DL, Blanco LJ, Kessler JC. Fundamentals of fixed prosthodontics. 4th ed. Chicago; Quintessence Publishing Co.; 2012. p. 81-98.
  17. Landry KE, Johnson PF, Parks VJ, Pelleu GB Jr. A photoelastic study to determine the location of the nonrigid connector in a five-unit intermediate abutment prosthesis. J Prosethet Dent 1987;57:454-7. https://doi.org/10.1016/0022-3913(87)90014-X
  18. Reynolds JM. Abutment selection for fixed prosthodontics. J Prosthet Dent 1968;19:483-8. https://doi.org/10.1016/0022-3913(68)90064-4
  19. Hung SH, Hung KS, Eick JD, Chappell RP. Marginal fit of porcelain-fused-to-metal and two types of ceramic crown. J Prosthet Dent 1990;63:26-31. https://doi.org/10.1016/0022-3913(90)90260-J
  20. Heschl A, Haas M, Haas J, Payer M, Wegscheider W, Polansky R. Maxillary rehabilitation of periodontally compromised patients with extensive onepiece fixed prosthesis supported by natural teeth: a retrospective longitudinal study. Clin Oral Investig 2013;17:45-53.