구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제38권1호
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  • Pages.42-51
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  • 2022
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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디지털 기법을 활용한 치과의사, 기공사, 그리고 환자 간의 효과적인 소통을 통한 전치부 임플란트의 진단 및 심미수복 증례

Usage of digital technique to facilitate communication between dentist, dental lab technician, and patients in diagnosis and restoration for maxillary anterior implant: a case report

  • 방혜민 (전남대학교 치의학전문대학원 보철학교실) ;
  • 장우형 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박찬 (전남대학교 치의학전문대학원 보철학교실) ;
  • 윤귀덕 (전남대학교 치의학전문대학원 보철학교실) ;
  • 임현필 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박상원 (전남대학교 치의학전문대학원 보철학교실)
  • Bang, Haemin (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Jang, Woohyung (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Chan (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Yun, Kwi-Dug (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Lim, Hyun-Pil (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Sangwon (Department of Prosthodontics, School of Dentistry, Chonnam National University)
  • 투고 : 2022.02.25
  • 심사 : 2022.03.02
  • 발행 : 2022.03.31
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초록

상악 전치부 임플란트 같이 심미성이 요구되는 부위의 보철수복은 임플란트 몸체의 식립각도에 영향을 많이 받는다. 순측으로 식립된 임플란트의 각도 때문에, 비심미적인 보철물의 결과가 예상되는 경우 치료에 앞서 환자와 임플란트 보철수복의 한계점을 논의하는 것은 매우 중요하다. 환자에게 치료의 한계점을 시각화하여 보여주기 위해 얼굴스캔 데이터와, CT 파일, 그리고 구내스캔을 중첩하여 디지털진단왁스업을 시행하여 환자에게 제시하였다. 환자는 순측으로 돌출된 보철물의 디자인에 불만족하였다. 환자의 의견을 반영하기 위해 3D 데이터를 이용하여 사고로 인해 이미 근관치료된 인접치를 포함한 새로운 디자인을 제시하고, 기공실팀과 함께 환자의 의견이 반영된 보철물을 제작하였다. 환자는 자신의 의견이 반영된 보철물에 심미적 및 기능적으로 만족하였다.

Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.

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