The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Implant treatment on anterior cross-bite of a patient who had orthognathic surgery 20 years ago

20년전 악교정수술을 받았던 환자의 심한 전치부 반대교합의 해결을 위한 임플란트 치료 증례

  • Park, Kwang Man (Department of Biomaterials & Prosthodontics, Kyung Hee University Dental Hospital at Gangdong) ;
  • Leesungbok, Richard (Department of Biomaterials & Prosthodontics, Kyung Hee University Dental Hospital at Gangdong) ;
  • Lee, Suk Won (Department of Biomaterials & Prosthodontics, Kyung Hee University Dental Hospital at Gangdong)
  • 박광만 (경희대학교 치과대학 강동경희치대병원 생체재료 보철과) ;
  • 이성복 (경희대학교 치과대학 강동경희치대병원 생체재료 보철과) ;
  • 이석원 (경희대학교 치과대학 강동경희치대병원 생체재료 보철과)
  • Received : 2019.03.08
  • Accepted : 2019.05.15
  • Published : 2019.07.31
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Abstract

Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

골격성 3급 부정교합의 악교정 수술로 구강기능과 안모를 개선할 수 있다. 악골부조화가 클수록 술전 교정치료에 의한 치아 이동량이 더욱 커지기 때문에 치주조직에도 큰 변화를 줄 수 있는데, 특히 하악 전치부 치주조직의 파괴가 주로 발생된다. 이 보고는 20년전 골격성 3급 부정교합과 하악전돌로 악교정수술을 받은 후 하악 전치부의 심한 동요 및 반대교합의 해결을 위해 내원한 49세 여성환자의 증례로, Face Hunter, Plane System 및 ARCUS digma II를 이용하여 Top-Down concept의 개인 맞춤형 분석으로 치료계획을 수립하였다. 하악 전치부 발치를 동반한 순측 치조골 성형술과 임플란트 식립 후 즉시임시치관에 의한 즉시부하를 시행하였다. 최종 보철물은 CAD/CAM에 의한 Zirconia 수복물로 제작 후 구강 내에서 나사유지형으로 장착하였다. 6개월이 경과한 현재까지 보철물의 파절과 동요 등은 관찰되지 않았으며, 기능 및 심미적으로 만족스러운 결과를 얻었기에 보고하고자 한다.

Keywords

References

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