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다운증후군 성인환자의 완전구강회복을 위한 피개 의치와 고정성 보철물 적용치료 : 증례보고

FIXED PROSTHESES AND OVERDENTURE TREATMENT OF A PATIENTS WITH DOWN SYNDROME: CASE REPORT

  • 임경철 (서울대학교 치의학대학원 예방치학교실) ;
  • 이재영 (서울대학교 치의학대학원 예방치학교실) ;
  • 김영재 (서울대학교 치의학대학원 소아치과학교실) ;
  • 진보형 (서울대학교 치의학대학원 예방치학교실)
  • Lim, Kyung-Cheol (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University) ;
  • Lee, Jae-Young (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Young-Jae (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Jin, Bo-Hyoung (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University)
  • 투고 : 2018.10.01
  • 심사 : 2018.11.23
  • 발행 : 2018.12.31

초록

이번 증례에서는 다수의 치아우식증과 치주질환이 있는 다운증후군 환자의 구강완전회복을 위해 수복치료 시 고려해야 할 부분에 대해 살펴보았다. 다운증후군 환자의 경우 포괄적인 보철치료를 받았다 할지라도 보호자 동반의 지속적 구강건강관리가 필요하며, 또한 치료 시 환자뿐만 아니라 보호자에게 치료와 관리방법에 대한 설명을 수행하는 것, 치료 전 구강건강상태와 구강관리습관, 전신 병력과 교육 여부도 보철치료의 성공적 예후에 매우 중요한 요소가 된다. 결과적으로 다운증후군환자의 단순발치에서부터 치주치료, 보철치료 등 치과적 치료 적용 시 다양한 요인들을 파악하고, 보호자 환자와의 라포 형성, 경제적 상황에 맞는 치과치료 선택 등 올어라운드(all-around) 형태의 치료계획 수립이 성공적인 치과 치료를 가능하게하며, 나아가 환자의 삶의 질을 개선시키고 건강한 삶을 영위할 수 있도록 할 수 있다.

A 20-year-old male patient with Down syndrome presented with rampant caries and chronic periodontitis on full-mouth. Patient have many oral diseases despite of no abnormalities of medical history, no involuntary tremor, no excessive masticatory pressure, and no limitation of exercise. Also he had no experiences of oral health education of prostheses and oral health management. Therefore, A number of fixed prostheses and denture treatments were performed to caregiver and patient with education for oral hygiene and management. After delivery final prostheses, they had repeated follow-up for checking management.

키워드

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Fig. 1. Pre-treatment status of entire oral health conditions through intra-oral clinical examination.

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Fig. 2. Pre-treatment panoramic view.

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Fig. 3. Post-treatment status of entire oral health conditions through intra-oral clinical examination (Restore upper molar areas with removable partial denture with PFM bridge, etc).

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Fig. 4. Post-treatment panoramic view.

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Fig. 5. Final images of the fixed prosthodontics on the study models.

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Fig. 6. Final images of the partial dentures on the study models.

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