DOI QR코드

DOI QR Code

기존 임플란트 보철물의 불량한 유지관리를 개선하기 위해 임플란트 피개의치로의 상부 보철물 전환 증례

Rehabilitation of a patient by converting poorly maintained fixed implant prosthesis into implant overdenture: a case report

  • 김영규 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 정창모 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 윤미정 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 이소현 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 허중보 (부산대학교 치의학전문대학원 치과보철학교실)
  • Kim, Yeong-Kyu (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Jeong, Chang-Mo (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Yun, Mi-Jung (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Lee, So-Hyoun (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Huh, Jung-Bo (Department of Prosthodontics, School of Dentistry, Pusan National University)
  • 투고 : 2021.10.08
  • 심사 : 2021.12.29
  • 발행 : 2022.01.28

초록

임플란트 실패의 경우에서 과도한 하중 및 염증이 실패율을 높이는 대표적인 원인이 된다. 특히, 임플란트 주변의 불량한 구강위생은 임플란트 실패의 가장 흔한 원인 중 하나이다. 임플란트 상부보철물의 실패가 발생할 경우, 임상의는 남은 고정체를 사용하여 재진단하고 평가하여 치료계획을 수립해야 한다. 임플란트를 추가 식립하여 새로운 보철물을 만들거나 남은 임플란트를 이용하여 임플란트 융합 가철성 의치 및 임플란트 피개의치로 치료를 시행할 수 있다. 본 증례의 환자는 상악 무치악부를 고정성 임플란트 보철물로 수복한 후 구강위생관리가 불가하여 임플란트 보철물 실패한 환자에서 잔존 임플란트의 지대주 및 부가적인 유지 장치를 장착한 milled bar를 이용하여 가철성 임플란트 피개의치로 전환하여 치료하였고 심미성과 저작기능, 지속적인 유지관리 면에서 장기적으로 만족할 만한 결과를 얻었기에 보고하는 바이다.

Among many contributing factors of implant failure, excessive loading and inflammation contribute mainly to increasing implant failure rate. Especially, poor oral hygiene around implants is one of the most common reasons for implant failure. When implant prosthesis fails to function, the clinician should re-diagnose and plan treatment using the remaining implants. Additional implantation may be needed to make a new type of prosthesis or either implant-assisted RPD and implant overdenture treatment may be performed using the remaining implants. In this article, a patient whose fixed implant prosthesis in the maxilla had failed of poor oral hygiene maintenance was reported to be recovered with removable implant overdenture by using remaining implant abutments and a milled bar with additional retentive elements. Through this treatment, the clinical results were satisfactory in terms of esthetics, masticatory function recovery and oral hygiene management.

키워드

과제정보

This paper was supported by the grant of clinical research funding of the Dental Hospital of Pusan National University in 2020.

참고문헌

  1. DeBoer J. Edentulous implants: overdenture versus fixed. J Prosthet Dent 1993;69:386-90. https://doi.org/10.1016/0022-3913(93)90186-R
  2. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002;29:197-212. https://doi.org/10.1034/j.1600-051X.29.s3.12.x
  3. Misch K, Wang HL. Implant surgery complications: etiology and treatment. Implant Dent 2008;17:159-68. https://doi.org/10.1097/ID.0b013e3181752f61
  4. Lindquist LW, Carlsson GE, Jemt T. A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. Clin Oral Implants Res 1996;7:329-36. https://doi.org/10.1034/j.1600-0501.1996.070405.x
  5. Tang Z, Sha Y, Lin Y, Zhang G, Wang X, Cao C. Peri-implant mucosal inflammation and bone loss: clinical and radiographic evaluation of 108 dental implants after 1-year loading. Chin J Dent Res 2000;3:15-20.
  6. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90:121-32. https://doi.org/10.1016/S0022-3913(03)00212-9
  7. Thomason JM, Heydecke G, Feine JS, Ellis JS. How do patients perceive the benefit of reconstructive dentistry with regard to oral health-related quality of life and patient satisfaction? A systematic review. Clin Oral Implants Res 2007;18:168-88. https://doi.org/10.1111/j.1600-0501.2007.01461.x
  8. 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
  9. Zitzmann NU, Marinello CP. Treatment plan for restoring the edentulous maxilla with implant-supported restorations: removable overdenture versus fixed partial denture design. J Prosthet Dent 1999;82:188-96. https://doi.org/10.1016/S0022-3913(99)70155-1
  10. Walton JN, MacEntee MI, Glick N. One-year prosthetic outcomes with implant overdentures: a randomized clinical trial. Int J Oral Maxillofac Implants 2002;17:391-8.
  11. Choi JW, Bae JH, Jeong CM, Huh JB. Retention and wear behaviors of two implant overdenture stud-type attachments at different implant angulations. J Prosthet Dent 2017;117:628-35. https://doi.org/10.1016/j.prosdent.2016.09.027
  12. Choi JW, Choi KH, Chae HJ, Chae SK, Bae EB, Lee JJ, Lee SH, Jeong CM, Huh JB. Load-bearing capacity and retention of newly developed micro-locking implant prosthetic system: an in vitro pilot study. Materials (Basel) 2018;11:564. https://doi.org/10.3390/ma11040564
  13. Choi JW, Lee JJ, Bae EB, Huh JB. Implant-supported fixed dental prosthesis with a microlocking implant prosthetic system: A clinical report. J Prosthet Dent 2020;123:15-9. https://doi.org/10.1016/j.prosdent.2018.11.021
  14. Choi JW, Song CH, Huh JB. Implant-supported fixed dental prostheses with new retention type using zirconia ball and nickel-titanium spring. Implantology 2019;23:16-24. https://doi.org/10.32542/implantology.2019002
  15. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 1998;106:721-64. https://doi.org/10.1046/j.0909-8836..t01-6-.x
  16. Block MS, Kent JN. Long-term follow-up on hydroxylapatite-coated cylindrical dental implants: a comparison between developmental and recent periods. J Oral Maxillofac Surg 1994;52:937-43. https://doi.org/10.1016/S0278-2391(10)80074-6
  17. Mardinger O, Ben Zvi Y, Chaushu G, Nissan J, Manor Y. A retrospective analysis of replacing dental implants in previously failed sites. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:290-3. https://doi.org/10.1016/j.tripleo.2011.07.010
  18. Oh SL, Shiau HJ, Reynolds MA. Survival of dental implants at sites after implant failure: A systematic review. J Prosthet Dent 2020;123:54-60. https://doi.org/10.1016/j.prosdent.2018.11.007
  19. Naert I, Gizani S, Vuylsteke M, van Steenberghe D. A 5-year randomized clinical trial on the influence of splinted and unsplinted oral implants in the mandibular overdenture therapy. Part I: Peri-implant outcome. Clin Oral Implants Res 1998;9:170-7. https://doi.org/10.1034/j.1600-0501.1998.090304.x
  20. Schneider AL, Kurtzman GM. Restoration of divergent free-standing implants in the maxilla. J Oral Implantol 2002;28:113-6. https://doi.org/10.1563/1548-1336(2002)028<0113:RODFII>2.3.CO;2