The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Prosthetic reconstruction of maxillary defect resulting from a traumatic fall in an elderly patient: A case report

낙상에 의해 상악 전치부에 외상을 입은 노인 환자에서 수술을 배제하고 고정성 보철물을 이용하여 수복한 증례

  • Bae, Yoonjoo (Department of Prosthodontics, Hanil General Hospital) ;
  • Choi, Sunyoung (Department of Prosthodontics, Hanil General Hospital)
  • 배윤주 (한전의료재단 한일병원 치과 보철과) ;
  • 최순영 (한전의료재단 한일병원 치과 보철과)
  • Received : 2018.08.22
  • Accepted : 2018.09.13
  • Published : 2019.01.31
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Abstract

Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.

낙상에 의해 치아 및 주변 조직이 손상되어 구강 내 경조직 및 연조직의 상실이 발생한 경우 이를 재건하기 위한 방법으로 외과적 접근법과 보철적 접근법이 제시될 수 있다. 치은부가 포함된 보철물을 이용하는 보철적 접근법은 외과적 수술을 생략함으로써 치료 과정을 단순화 하고 치료 시간과 비용을 줄일 수 있다는 장점이 있다. 특히, 상악 전치부 치아 및 치조골의 상실을 보철적으로 재건하는 경우 치은부가 포함된 보철물에 의해 확실한 안면부 지지를 제공하게 되어 안모의 심미적 결손을 보상할 수 있고 상 하악의 관계를 개선시킬 수 있다. 본 증례는 낙상으로 인해 상악 전치부에 광범위한 손상을 입은 노인 환자에서 수술을 배제하고, 치은 색상의 도재가 포함된 고정성 보철물을 이용하여 수복함으로써 예지성 있는 심미적 결과를 얻었기에 이를 보고하고자 한다.

Keywords

References

  1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701-7. https://doi.org/10.1056/NEJM198812293192604
  2. Aschkenasy MT, Rothenhaus TC. Trauma and falls in the elderly. Emerg Med Clin North Am 2006;24:413-32, vii. https://doi.org/10.1016/j.emc.2006.01.005
  3. Boltz MM, Podany AB, Hollenbeak CS, Armen SB. Injuries and outcomes associated with traumatic falls in the elderly population on oral anticoagulant therapy. Injury 2015;46:1765-71. https://doi.org/10.1016/j.injury.2015.06.013
  4. Sattin RW. Falls among older persons: a public health perspective. Annu Rev Public Health 1992;13:489-508. https://doi.org/10.1146/annurev.pu.13.050192.002421
  5. Callaway DW, Wolfe R. Geriatric trauma. Emerg Med Clin North Am 2007;25:837-60. https://doi.org/10.1016/j.emc.2007.06.005
  6. Gutmann JL, Gutmann MS. Cause, incidence, and prevention of trauma to teeth. Dent Clin North Am 1995;39:1-13.
  7. Bastone EB, Freer TJ, McNamara JR. Epidemiology of dental trauma: a review of the literature. Aust Dent J 2000;45:2-9. https://doi.org/10.1111/j.1834-7819.2000.tb00234.x
  8. Fradeani M. Esthetic rehabilitation in fixed prosthodontics. Vol 1. Esthetic analysis - a systematic approach to prosthetic treatment. Chicgo, IL, USA; Quintessence Publishing Co.; 2004. p. 278-91.
  9. Coachman C, Salama M, Garber D, Calamita M, Salama H, Cabral G. Prosthetic gingival reconstruction in a fixed partial restoration. Part 1: introduction to artificial gingiva as an alternative therapy. Int J Periodontics Restorative Dent 2009;29:471-7.
  10. Malament KA, Neeser S. Prosthodontic management of ridge deficiencies. Dent Clin North Am 2004;48:735-44. https://doi.org/10.1016/j.cden.2004.04.001
  11. Behrend DA. The design of multiple pontics. J Prosthet Dent 1981;46:634-8. https://doi.org/10.1016/0022-3913(81)90070-6
  12. Alani A, Maglad A, Nohl F. The prosthetic management of gingival aesthetics. Br Dent J 2011;210:63-9. https://doi.org/10.1038/sj.bdj.2011.2
  13. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, Bourguignon C, DiAngelis A, Hicks L, Sigurdsson A, Trope M, Tsukiboshi M, von Arx T; International Association of Dental Traumatology. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 2007;23:66-71. https://doi.org/10.1111/j.1600-9657.2007.00592.x
  14. Compton SM, Clark D, Chan S, Kuc I, Wubie BA, Levin L. Dental implants in the elderly population: A long-term followup. Int J Oral Maxillofac Implants 2017;32:164-70. https://doi.org/10.11607/jomi.5305
  15. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004;19:43-61.
  16. Fuentealba R, Jofre J. Esthetic failure in implant dentistry. Dent Clin North Am 2015;59:227-46. https://doi.org/10.1016/j.cden.2014.08.006
  17. Viana PC, Kovacs Z, Correia A. Purpose of esthetic risk assessment in prosthetic rehabilitations with gingiva-shade ceramics. Int J Esthet Dent 2014;9:480-9.
  18. Bhuvaneswaran M. Principles of smile design. J Conserv Dent 2010;13:225-32. https://doi.org/10.4103/0972-0707.73387