DOI QR코드

DOI QR Code

Implant overdenture of mandible with severe unilateral atrophy: Report of two cases

심한 편측 하악 치조골 흡수를 보이는 환자에서의 임플란트 피개의치 수복 증례

  • Kim, So-Yeun (Dental Clinic Center, Pusan National University Hospital) ;
  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Jung, Kyoung-Hwa (Dental Clinic Center, Pusan National University Hospital) ;
  • Jeon, Hye-Mi (Dental Clinic Center, Pusan National University Hospital) ;
  • Baek, Young-Jae (Dental Clinic Center, Pusan National University Hospital) ;
  • Yun, Mi-Jung (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Huh, Jung-Bo (Department of Prosthodontics, School of Dentistry, Pusan National University)
  • 김소연 (부산대학교병원 치과진료센터) ;
  • 권은영 (부산대학교병원 치과진료센터) ;
  • 정경화 (부산대학교병원 치과진료센터) ;
  • 전혜미 (부산대학교병원 치과진료센터) ;
  • 백영재 (부산대학교병원 치과진료센터) ;
  • 윤미정 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 허중보 (부산대학교 치의학전문대학원 치과보철학교실)
  • Received : 2019.03.25
  • Accepted : 2019.06.03
  • Published : 2019.07.31

Abstract

There are several unfavorable conditions regarding alveolar bone condition that may compromise the denture patient's satisfaction. Chewing efficiency may not be satisfactory when alveolar bone is deficient, and the denture stability could hardly be achieved when alveolar bone shape is irregular. Implant overdenture can be useful to provide satisfactory denture experience compared to conventional denture. The attachment for implant overdenture can be classified into bar attachment and solitary attachment. When the positions of the implants are in the mandibular anterior region, bar attachment may be favorable to obtain a rigid support of the entire denture. When implants are distributed both on anterior and posterior region, a solitary attachment could be considered for ease of removal and maintenance. This report presents implant overdenture cases with the patients that had unilateral mandibular alveolar bone atrophy conditions. Different abutments were chosen based on the individual patient's mandibular alveolar bone condition and the treatments were successful in terms of patient satisfaction.

심한 하악 치조골 흡수룰 보이는 완전 무치악 환자에서 의치는 환자의 저작 효율이 극히 저하되며 특히 치조골의 형태가 불규칙한 경우 의치의 안정성은 더 떨어질 수 있다. 이때 임플란트를 통한 지지를 얻는 피개의치를 통해 편안감 회복과 향후 지속적인 치조골 흡수를 줄이는데 도움을 줄 수 있다. 임플란트 피개의치를 위한 하방의 attachment는 크게 bar attachment와 solitary attachment로 나뉘며 임플란트 고정체의 위치가 하악 전방 치조골에 있으면서 의치 전체가 견고한 지지를 얻기 위해서는 bar attachment가 유리하고 구치부에도 고정체가 위치하며 쉬운 착탈과 유지관리의 편의를 얻고자 하면 solitary attachment를 고려할 수 있다. 본 증례는 환자의 상황에 따른 임플란트 식립 위치 결정, attachment를 선택을 통하여 임플란트 피개의치를 다양하게 적용하여 만족할만한 결과를 얻어 이를 보고하는 바이다.

Keywords

References

  1. van der Bilt A, Olthoff LW, van der Glas HW, van der Weelen K, Bosman F. A mathematical description of the comminution of food during mastication in man. Arch Oral Biol 1987;32:579-86. https://doi.org/10.1016/0003-9969(87)90067-7
  2. Wismeijer D, Van Waas MA, Vermeeren JI, Mulder J, Kalk W. Patient satisfaction with implant-supported mandibular overdentures. A comparison of three treatment strategies with ITIdental implants. Int J Oral Maxillofac Surg 1997;26:263-7.
  3. Naert I, Quirynen M, Theuniers G, van Steenberghe D. Prosthetic aspects of osseointegrated fixtures supporting overdentures. A 4-year report. J Prosthet Dent 1991;65:671-80. https://doi.org/10.1016/0022-3913(91)90205-B
  4. Trakas T, Michalakis K, Kang K, Hirayama H. Attachment systems for implant retained overdentures: a literature review. Implant Dent 2006;15:24-34. https://doi.org/10.1097/01.id.0000202419.21665.36
  5. Gotfredsen K, Holm B. Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study. Int J Prosthodont 2000;13:125-30.
  6. Abi Nader S, de Souza RF, Fortin D, De Koninck L, Fromentin O, Albuquerque Junior RF. Effect of simulated masticatory loading on the retention of stud attachments for implant overdentures. J Oral Rehabil 2011;38:157-64. https://doi.org/10.1111/j.1365-2842.2010.02145.x
  7. Burns DR. Mandibular implant overdenture treatment: consensus and controversy. J Prosthodont 2000;9:37-46. https://doi.org/10.1111/j.1532-849X.2000.00037.x
  8. Narhi TO, Geertman ME, Hevinga M, Abdo H, Kalk W. Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures. J Prosthet Dent 2000;84:43-9. https://doi.org/10.1067/mpr.2000.107113
  9. Lee JY, Yoon JY, Oh NS. The use of surgical guide stent for implant placement. J Korean Acad Prosthodont 2014;52:366-75. https://doi.org/10.4047/jkap.2014.52.4.366
  10. English CE. Bar patterns in implant prosthodontics. Implant Dent 1994;3:217-29. https://doi.org/10.1097/00008505-199412000-00002
  11. Takeshita S, Kanazawa M, Minakuchi S. Stress analysis of mandibular two-implant overdenture with different attachment systems. Dent Mater J 2011;30:928-34. https://doi.org/10.4012/dmj.2011-134
  12. Bergendal T, Engquist B. Implant-supported overdentures: a longitudinal prospective study. Int J Oral Maxillofac Implants 1998;13:253-62.
  13. Geckili O, Bilhan H, Bilgin T. $Locator^{(R)}$ attachments as an alternative to ball attachments in 2-implant retained mandibular overdentures. J Can Dent Assoc 2007;73:691-4.
  14. Min BK, Shin EJ, Vang MS, Yang HS, Park SW, Yun KD, Lim HP. Overdentures of the patient with Parkinson's disease: A case report. J Korean Acad Prosthodont 2015;53:352-8. https://doi.org/10.4047/jkap.2015.53.4.352