대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제62권4호
  • /
  • Pages.339-348
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  • 2024
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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기존 금속 구조물을 이용한 임플란트 지지 하이브리드 보철물의 재수복 증례

Retreatment of implant-supported hybrid prosthesis with existing metal framework: a case report

  • 채성훈 (고려대학교 구로병원 치과보철과) ;
  • 이한나 (고려대학교 구로병원 치과보철과) ;
  • 심지석 (고려대학교 구로병원 치과보철과) ;
  • 이정열 (고려대학교 구로병원 치과보철과)
  • Sung-Hoon Chai (Department of Prosthodontics, Korea University Guro Hospital) ;
  • Han-Na Lee (Department of Prosthodontics, Korea University Guro Hospital) ;
  • Ji-Suk Shim (Department of Prosthodontics, Korea University Guro Hospital) ;
  • Jeong-Yol Lee (Department of Prosthodontics, Korea University Guro Hospital)
  • 투고 : 2024.07.29
  • 심사 : 2024.09.18
  • 발행 : 2024.10.31
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초록

임플란트 지지 하이브리드 보철물은 금속 구조물과 아크릴릭 레진으로 구성된 고정성의 보철물로, 심미, 기능, 발음, 구순지지 등의 이점을 가지며, 임플란트를 금속 구조물로 연결 고정하여 유지와 지지도 함께 제공할 수 있다. 그러나 올바른 구강위생관리가 동반되지 않으면 임플란트 주위염이 발생할 수 있고, 장기간 사용 시 인공치의 마모나 파절로 저작기능 감소와 수직교합고경의 상실이 발생할 수 있다. 전통적으로는 새로운 금속 구조물을 주조하여 재제작해야 하지만, 기존 금속 구조물이 건전하다면 이를 재사용하여 보다 빠르고 간단하게 제작할 수 있다. 본 증례는 58세 남환으로 임플란트 주위염이 확인되어 일부 임플란트를 제거하고 치료한 후, 기존 금속 구조물을 이용해 상부 보철물을 재제작하였다. 기존 금속 구조물을 유지하여 임플란트 지지 하이브리드 보철물을 재제작함으로써 치료 기간과 내원 횟수를 줄여 환자의 불편을 최소화하였기에 이를 보고하는 바이다.

An implant-supported hybrid prosthesis is a fixed restoration composed of a metal framework and acrylic resin, offering advantages such as aesthetics, function, phonetics, and lip support, while providing retention and support through the splinting of implants with the metal framework. However, poor oral hygiene can lead to peri-implantitis, and long-term use may result in wear or fracture of the artificial teeth, causing reduced masticatory function and loss of vertical dimension. Traditionally, a new metal framework is cast for remanufacturing, but if the existing framework is intact, it can be reused for a more rapid and simplified protocol. This case involves a 58-year-old male patient with peri-implantitis, where some implants were removed and treated, and the superstructure was remanufactured using the existing metal framework. By preserving the existing metal framework during the remanufacturing of the implant-supported hybrid prosthesis, the treatment time and number of visits were reduced, minimizing patient discomfort.

키워드

참고문헌

  1. Kwon T, Bain PA, Levin L. Systematic review of short- (5-10 years) and long-term (10 years or more) survival and success of full-arch fixed dental hybrid prostheses and supporting implants. J Dent 2014;42:1228-41. 
  2. Gallucci GO, Doughtie CB, Hwang JW, Fiorellini JP, Weber HP. Five-year results of fixed implant-supported rehabilitations with distal cantilevers for the edentulous mandible. Clin Oral Implants Res 2009;20:601-7. 
  3. Egilmez F, Ergun G, Cekic-Nagas I, Bozkaya S. Implant-supported hybrid prosthesis: conventional treatment method for borderline cases. Eur J Dent 2015;9:442-8. 
  4. Branemark PI, Svensson B, van Steenberghe D. Tenyear survival rates of fixed prostheses on four or six implants ad modum Branemark in full edentulism. Clin Oral Implants Res 1995;6:227-31. 
  5. Zarb G, Jansson T. Laboratory procedures and protocol. In: Branemark PI, Zarb G, Albrektsson T (eds). Tissue integrated prostheses: osseointegration in clinical dentistry. Chicago: Quintessence. 1985. p. 303. 
  6. Hermann JS, Schoolfield JD, Schenk RK, Buser D, Cochran DL. Influence of the size of the microgap on crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged implants in the canine mandible. J Periodontol 2001;72:1372-83. 
  7. Malo P, Rangert B, Nobre M. "All-on-Four" immediate-function concept with Branemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res 2003;5 Suppl 1:2-9. 
  8. Guckes AD, Scurria MS, Shugars DA. A conceptual framework for understanding outcomes of oral implant therapy. J Prosthet Dent 1996;75:633-9. 
  9. Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2018;45 Suppl 20:S246-66. 
  10. Dalago HR, Schuldt Filho G, Rodrigues MA, Renvert S, Bianchini MA. Risk indicators for Peri-implantitis. A cross-sectional study with 916 implants. Clin Oral Implants Res 2017;28:144-50. 
  11. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90:121-32. 
  12. Drago C, Gurney L. Maintenance of implant hybrid prostheses: clinical and laboratory procedures. J Prosthodont 2013;22:28-35. 
  13. Schwarz F, Jepsen S, Obreja K, Galarraga-Vinueza ME, Ramanauskaite A. Surgical therapy of peri-implantitis. Periodontol 2000 2022;88:145-81. 
  14. Drago C, Howell K. Concepts for designing and fabricating metal implant frameworks for hybrid implant prostheses. J Prosthodont 2012;21:413-24. 
  15. Hermann JS, Schoolfield JD, Schenk RK, Buser D, Cochran DL. Influence of the size of the microgap on crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged implants in the canine mandible. J Periodontol 2001;72:1372-83. 
  16. McGlumphy EA, Mendel DA, Holloway JA. Implant screw mechanics. Dent Clin North Am 1998;42:71-89. 
  17. Sahin S, Cehreli MC. The significance of passive framework fit in implant prosthodontics: current status. Implant Dent 2001;10:85-92. 
  18. Heydecke G, Zwahlen M, Nicol A, Nisand D, Payer M, Renouard F, Grohmann P, Muhlemann S, Joda T. What is the optimal number of implants for fixed reconstructions: a systematic review. Clin Oral Implants Res 2012;23 Suppl 6:217-28. 
  19. Bhering CL, Mesquita MF, Kemmoku DT, Noritomi PY, Consani RL, Barao VA. Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study. Mater Sci Eng C Mater Biol Appl 2016;69:715-25. 
  20. Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Peri-implantitis - onset and pattern of progression. J Clin Periodontol 2016;43:383-8.