DOI QR코드

DOI QR Code

Combination syndrome 예방을 고려한 flexible IARPD 증례

Flexible IARPD considering the prevention of combination syndrome: a case report

  • 김소연 (경북대학교 치과대학 치과보철학교실)
  • Kim, So-yeun (Department of Prosthodontics, School of Dentistry, Kyungpook National University)
  • 투고 : 2022.07.19
  • 심사 : 2022.09.15
  • 발행 : 2022.10.31

초록

상악 완전 무치악과 하악 양측 후방 무치악 상태의 환자에서 전통적인 의치를 제작하는 방법은 흔히 볼수 있는 치료 방법이다. 그러나 장기적으로 볼 때 이와 같은 구강내 환경에서는 복합증후군(Combination syndrome)이라는 합병증이 발생할 수 있다. 이때 임플란트를 동반한 국소의치(Implant Assisted Removable Partial Denture, IARPD)의 적용으로 치조골 보존과 함께 Combination syndrome의 예방을 도모할 수 있다. 본 증례에서는 무치악 부위에 임플란트의 추가 식립 시 국소의치의 움직임에 의해 최후방 지대치에 가해지는 응력을 줄일 수 있으므로 금속이 아닌 레진 클라스프를 계획하였고 flexible 의치 레진을 사용하였다. 상악 총의치, 하악 flexible IARPD를 계획하여 최소한의 비용과 수술로서 심미적, 기능적인 장기적 예후를 얻어 보고하고자 한다.

Traditional denture treatment is often performed in patients with the completely edentulous maxilla and the bilateral edentulous posterior mandible. However, with a long-term prognosis, a complication called 'combination syndrome' may occur in this oral environment. In this case, by applying an implant-assisted removable partial denture (IARPD), it is possible to preserve the alveolar bone and prevent combination syndrome. In this case, when additional implants are placed in the edentulous area, the stress applied to the abutment due to the movement of the removable denture can be reduced, so it is possible to design an esthetic clasp using resin rather than metal, and flexible denture base resin is used. As a treatment for maxillary complete denture and mandibular flexible IARPD, it showed an esthetic and functional long-term prognosis with minimal cost and surgery.

키워드

참고문헌

  1. Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil 2008;35:72-9. https://doi.org/10.1111/j.1365-2842.2007.01824.x
  2. Friel T, Waia S. Removable partial dentures for older adults. Prim Dent J 2020;9:34-9. https://doi.org/10.1177/2050168420943435
  3. Reich KM, Huber CD, Lippnig WR, Ulm C, Watzek G, Tangl S. Atrophy of the residual alveolar ridge following tooth loss in an historical population. Oral Dis 2011;17:33-44. https://doi.org/10.1111/j.1601-0825.2010.01699.x
  4. Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. 1972. J Prosthet Dent 2003;90:213-9. https://doi.org/10.1016/S0022-3913(03)00240-3
  5. Saunders TR, Gillis RE Jr, Desjardins RP. The maxillary complete denture opposing the mandibular bilateral distal-extension partial denture: treatment considerations. J Prosthet Dent 1979;41:124-8. https://doi.org/10.1016/0022-3913(79)90292-0
  6. Keltjens HM, Kayser AF, Hertel R, Battistuzzi PG. Distal extension removable partial dentures supported by implants and residual teeth: considerations and case reports. Int J Oral Maxillofac Implants 1993;8:208-13.
  7. Zancope K, Abrao GM, Karam FK, Neves FD. Placement of a distal implant to convert a mandibular removable Kennedy class I to an implant-supported partial removable Class III dental prosthesis: A systematic review. J Prosthet Dent 2015;113:528-33. https://doi.org/10.1016/j.prosdent.2014.12.011
  8. von Wowern N, Gotfredsen K. Implant-supported overdentures, a prevention of bone loss in edentulous mandibles? A 5-year follow-up study. Clin Oral Implants Res 2001;12:19-25. https://doi.org/10.1034/j.1600-0501.2001.012001019.x
  9. Bassetti RG, Bassetti MA, Kuttenberger J. Implant-assisted removable partial denture prostheses: A critical review of selected literature. Int J Prosthodont 2018;31:287-302. https://doi.org/10.11607/ijp.5227
  10. Ohyama T, Nakabayashi S, Yasuda H, Kase T, Namaki S. Mechanical analysis of the effects of implant position and abutment height on implant-assisted removable partial dentures. J Prosthodont Res 2020;64:340-5. https://doi.org/10.1016/j.jpor.2019.09.007
  11. ELsyad MA, Errabti HM, Mustafa AZ. Mandibular denture base deformation with locator and ball attachments of implant-retained overdentures. J Prosthodont 2016;25:656-64. https://doi.org/10.1111/jopr.12356
  12. Nogawa T, Saito M, Murashima N, Takayama Y, Yokoyama A. Influence of rigidity of retainers on dynamic behavior of implant-supported removable partial dentures. Int J Implant Dent 2020;6:1-9. https://doi.org/10.1186/s40729-019-0197-z
  13. Akinyamoju CA, Dosumu OO, Taiwo JO, Ogunrinde TJ, Akinyamoju AO. Oral health-related quality of life: acrylic versus flexible partial dentures. Ghana Med J 2019;53:163-9. https://doi.org/10.4314/gmj.v53i2.12
  14. Yunus N, Rashid AA, Azmi LL, Abu-Hassan MI. Some flexural properties of a nylon denture base polymer. J Oral Rehabil 2005;32:65-71. https://doi.org/10.1111/j.1365-2842.2004.01370.x
  15. Singh JP, Dhiman RK, Bedi RP, Girish SH. Flexible denture base material: A viable alternative to conventional acrylic denture base material. Contemp Clin Dent 2011;2:313-7. https://doi.org/10.4103/0976-237X.91795
  16. Saeed F, Muhammad N, Khan AS, Sharif F, Rahim A, Ahmad P, Irfan M. Prosthodontics dental materials: From conventional to unconventional. Mater Sci Eng C Mater Biol Appl 2020;106:110167. https://doi.org/10.1016/j.msec.2019.110167
  17. Al-Dharrab A, Shinawi L. Thermogravimetric Characterization of the microstructui composition of polyamide injection molded denture base material vs conventional compression molded heat-cured denture base material. J Contemp Dent Pract 2016;17:99-104. https://doi.org/10.5005/jp-journals-10024-1810
  18. Bogucki ZA, Kownacka M. Elastic dental prostheses - alternative solutions for patients using acrylic prostheses: Literature review. Adv Clin Exp Med 2018;27:1441-5. https://doi.org/10.17219/acem/70044