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Re-establishment of occlusal plane in a patient with a failed implant prosthesis

실패한 임플란트 보철수복물을 가진 환자의 교합평면 재설정

  • Kang, Hyeon-Goo (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Ko, Kyung-Ho (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Huh, Yoon-Hyuk (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University)
  • 강현구 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 고경호 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 허윤혁 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소)
  • Received : 2017.10.26
  • Accepted : 2018.02.28
  • Published : 2018.04.30

Abstract

A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

계속적인 치아의 상실과 마모 및 보철물의 실패로 초래된 생리적이지 못한 교합평면은 비심미성, 저작 효율의 감소 및 교합 간섭와 같은 기능적인 문제을 야기할 수 있다. 따라서, 무치악 환자나 교합 평면이 붕괴된 환자의 보철 치료 시, 저작 기능과 조화로운 교합평면의 설정이 중요하다. 본 증례의 환자는 완전 무치악 상태인 상악을 임플란트 고정성 보철물로 수복하였다. 6년 경과 관찰 시, 기존 임플란트 보철물의 도재 파절, 마모, 나사풀림과 같은 기계적 합병증이 관찰되었고, 대합하는 전치의 마모 및 정출과 일부 구치부 치아의 상실로 인해 교합평면이 붕괴된 상태였다. 진단 과정을 거쳐 무치악 부위의 추가적인 임플란트 식립과 보철물의 재제작 및 모든 잔존 치아의 수복을 통해 전악구강회복을 시행하였다.

Keywords

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