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Implant-assisted overdenture using milled bar and ADD-TOC in edentulous maxilla: A case report

상악 무치악 환자에서 Milled Bar와 ADD-TOC을 이용한 임플란트 피개의치 수복 증례

  • Jo, Yong-Bum (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Jeong, Chang-Mo (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Huh, Jung-Bo (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) ;
  • Kim, Min-Jung (Department of Prosthodontics, School of Dentistry, Pusan National University)
  • 조용범 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 정창모 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 허중보 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 윤미정 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 이소현 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 김민정 (부산대학교 치의학전문대학원 치과보철학교실)
  • Received : 2021.10.09
  • Accepted : 2021.12.08
  • Published : 2022.04.30

Abstract

One of the treatment options for edentulous state patients with residual ridge resorption is implant overdenture using milled bar and attachment. It not only provides improved retention and stability but can also reduce the coverage of palatal surface. In addition, when a small number of implants are used, milled bar has the effect of being splinted between implant fixtures, which makes it mechanically advantageous under functions such as mastication. The patient in this case was a maxillary edentulous state patient with a considerable amount of residual alveolar bone resorption after removing the existing failed implants. Three implants were planted on both sides and an implant overdenture was fabricated using milled bar and ADD-TOC attachment.

잔존골 흡수가 진행된 상악 무치악 환자의 수복 계획시 전통적인 총의치로의 치료보다는 임플란트를 식립 한 뒤 milled bar와 가철성 보철물을 제작하여 attachment로 연결하는 임플란트 피개의치를 우선적으로 고려할 수 있다. Milled bar와 attachment를 사용하면 상악 의치의 유지력 및 안정성의 증가뿐만 아니라 구개 피개 부위를 일부 감소시킬 수 있어 환자의 불편감을 줄여줄 수 있다는 장점이 있다. 또한 소수의 임플란트를 식립 할 경우 상부 보철물을 milled bar로 제작하면 임플란트 고정체 간에 연결고정되는 효과가 있어 저작과 같은 기능 하에서 역학적으로 유리해진다. 본 증례의 환자는 기존의 실패한 임플란트를 제거한 뒤 잔존 치조골이 상당량 소실된 상악 무치악 환자로 양측에 각 3개의 임플란트를 식립한 후 milled bar와 ADD-TOC attachment를 사용하여 임플란트 피개의치를 제작하였다. Attachment 장착을 통해 얻어진 부가적인 유지력을 바탕으로 구개부 피개량 감소하여 총의치 제작 가능하였고 이렇게 milled bar와 attachment를 병용하여 충분한 유지력 뿐만아니라 지지 및 안정을 얻음으로써 심미성 및 기능성 모두에서 만족할 만한 결과를 얻었기에 보고하는 바이다.

Keywords

Acknowledgement

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

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