대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제56권1호
  • /
  • Pages.56-63
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  • 2018
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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전반적인 치아 마모로 수직 고경이 상실된 항응고제 복용 고령 환자의 전악 수복 증례

Full mouth rehabilitation of the elderly patient on anticoagulant medication with loss of vertical dimension due to severely worn dentition

  • 강철근 (서울대학교 치의학대학원 치과보철학교실) ;
  • 허성주 (서울대학교 치의학대학원 치과보철학교실) ;
  • 김성균 (서울대학교 치의학대학원 치과보철학교실) ;
  • 곽재영 (서울대학교 치의학대학원 치과보철학교실)
  • Kang, Cheol-Keun (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Heo, Seong-Joo (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Kim, Seong-Kyun (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Koak, Jai-Young (Department of Prosthodontics, School of Dentistry, Seoul National University)
  • 투고 : 2017.08.08
  • 심사 : 2017.09.20
  • 발행 : 2018.01.31
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초록

과도한 치아의 마모는 치수의 병적변화, 교합평면의 붕괴 기능적 및 심미적 문제를 야기하고, 수직 고경의 감소를 야기할 수 있다. 수직고경을 회복시키는 전악 보철 수복을 할 때에는 주의 깊은 진단과 분석을 통해 적절한 수직 고경 거상량을 결정하는 것이 중요하다. 본 증례는 77세 항응고제 복용중인 고령의 남성으로 전반적인 치아의 마모와 파절로 수직고경이 감소된 환자이다. 체계적인 분석을 통해 환자의 상태를 진단하여, 수직고경을 새롭게 설정하였다. 전신질환 및 고령의 나이를 고려하여 단계적 치료과정을 통해 증가된 수직 고경의 적절성 여부를 판단하였다. 이를 기반으로 최종 고정성 보철물을 통해 완전 구강 회복술 시행하였으며, 이에 기능적, 심미적으로 만족스러운 결과를 보였다.

Severe dental attrition causes pathological changes of the tooth, collapsed occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension. Before increasing the vertical dimension with full-mouth rehabilitation, it is important to determine the amount of vertical dimension through accurate diagnosis. In this case, a 77 year old elderly male patient on anticoagulant medication with generalized attrition and fracture of teeth was treated with full-mouth rehabilitation in order to recover vertical dimension and aesthetics. Accurate clinical and radiographic examination, diagnostic, wax-up, and occlusal vertical dimension evaluation were step by step performed considering pre-medical history and old age. Patient adaptability was evaluated using an occlusal splint and interim restoration. After 3 months of stabilization with interim restoration, definitive prostheses were fabricated. Satisfactory functional and esthetic outcomes are observed after 6 months of follow up.

키워드

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