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양측 구치부 교합평면의 기울어짐과 이부의 비대칭이 있는 환자에서 디지털 가상환자를 이용한 상악 전치부 심미 수복 증례

Aesthetic restoration of maxillary anterior teeth in patient with tilted occlusal plane on both posterior parts and asymmetry of the chin using virtual patient: a case report

  • 이승주 (전북대학교 치과대학 치과보철학교실 및 구강생체과학연구소) ;
  • 이정진 (전북대학교 치과대학 치과보철학교실 및 구강생체과학연구소) ;
  • 박연희 (전북대학교 치과대학 치과보철학교실 및 구강생체과학연구소) ;
  • 안승근 (전북대학교 치과대학 치과보철학교실 및 구강생체과학연구소) ;
  • 김경아 (을지대학교 의과대학 치과학교실) ;
  • 서재민 (전북대학교 치과대학 치과보철학교실 및 구강생체과학연구소)
  • Seung-Ju Lee (Department of Prosthodontics, School of Dentistry, Jeonbuk National University) ;
  • Jung-Jin Lee (Department of Prosthodontics, School of Dentistry, Jeonbuk National University) ;
  • Yeon-Hee Park (Department of Prosthodontics, School of Dentistry, Jeonbuk National University) ;
  • Seung-Geun Ahn (Department of Prosthodontics, School of Dentistry, Jeonbuk National University) ;
  • Kyoung-A Kim (Department of Dentistry, School of Medicine, Eulji University) ;
  • Jae-Min Seo (Department of Prosthodontics, School of Dentistry, Jeonbuk National University)
  • 투고 : 2024.08.28
  • 심사 : 2024.09.30
  • 발행 : 2024.10.31

초록

전치부 심미 치료 시에는 보철물 자체의 색상, 형태, 질감과 함께 안모와의 조화를 중요하게 고려해야 한다. 최근 디지털 기술의 발달로 구강 스캔 데이터와 함께 안면 스캔, 하악 움직임 기록 데이터를 통합하여 형성한 가상 환자를 사용하여 보다 심미적이고 기능적인 보철물 제작이 가능해졌다. 본 증례 보고는 기울어진 교합 평면과 안면 비대칭이 있는 환자에서 가상환자를 통해 상악 전치부 임플란트 및 치아 지지 고정성 보철물을 수복하였다. 구내와 안면스캔 데이터, 교합 데이터를 획득하여 가상 환자를 구축하였고, 이를 통해 치료과정에서 안모와 조화를 이루는 보철물의 설계 및 제작이 보다 용이했으며, 치과의사와 환자, 치과기공사 사이에서 원활하고 직관적인 의사소통이 가능했다. 보철 치료 후 심미적 및 기능적으로 만족할 만한 결과를 보였기에 이를 보고하는 바이다.

In esthetic prosthetic treatment, color, shape, texture of teeth, and harmony with the facial appearance are considered very important. The virtual patient is formed by integrating data from intraoral and facial scans and mandibular movement records, making fabricating more aesthetic and functional prostheses possible in digital dentistry. In this case report, the patient with the tilted occlusal plane and facial asymmetry was restored with an anterior maxillary implant and a tooth-supported fixed prosthesis using the virtual patient. By using a virtual patient, it was possible to communicate between the dentist and patient or the dental technician during the design process, and we report this case because the results showed satisfactory aesthetic and functional results after treatment.

키워드

참고문헌

  1. McLaren EA, Culp L. Smile analysis. J Cosmet Dent 2013;29:94-108.
  2. Hong S, Lee Y, Hong SJ, Paek J, Noh K, Pae A, Kim HS, Kwon KR. Using 3-dimensional digital smile design in esthetic restoration of anterior teeth: a case report. J Korean Acad Prosthodont 2021;59:451-8.
  3. Li Q, Bi M, Yang K, Liu W. The creation of a virtual dental patient with dynamic occlusion and its application in esthetic dentistry. J Prosthet Dent 2021;126:14-8.
  4. Hong SJ, Noh K. Setting the sagittal condylar inclination on a virtual articulator by using a facial and intraoral scan of the protrusive interocclusal position: A dental technique. J Prosthet Dent 2021;125:392-5.
  5. An SJ, Shin SY, Choi YS. Creation of the dental virtual patients with dynamic occlusion and its application in esthetic dentistry. J Korean Acad Prosthodont 2022;60:222-30.
  6. Kim JE, Park JH, Moon HS, Shim JS. Complete assessment of occlusal dynamics and establishment of a digital workflow by using target tracking with a three-dimensional facial scanner. J Prosthodont Res 2019;63:120-4.
  7. Ma L, Liu F, Mei J, Chao J, Wang Z, Shen J. A comparative study to measure the sagittal condylar inclination using mechanical articulator, virtual articulator and jaw tracking device. J Adv Prosthodont 2023;15:11-21.
  8. Yang S, Feng N, Li D, Wu Y, Yue L, Yuan Q. A novel technique to align the intraoral scans to the virtual articulator and set the patient-specific sagittal condylar inclination. J Prosthodont 2022;31:79-84.
  9. Park YH, Ahn SG, Kim KA, Seo JM. Esthetic considerations for anterior implant-supported prostheses: focus on surgical and prosthetic treatment. J Dent Rehabil Appl Sci 2021;37:186-98.
  10. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992;63:995-6.
  11. Silva BP, Mahn E, Stanley K, Coachman C. The facial flow concept: an organic orofacial analysis-the vertical component. J Prosthet Dent 2019;121:189-94.
  12. Silva BP, Jimenez-Castellanos E, Stanley K, Mahn E, Coachman C, Finkel S. Layperson's perception of axial midline angulation in asymmetric faces. J Esthet Restor Dent 2018;30:119-25.
  13. Murray H, Locker D, Mock D, Tenenbaum H. Patient satisfaction with a consultation at a cranio-facial pain unit. Community Dent Health 1997;14:69-73.
  14. Tuncel I, Turp I, usumez A. Evaluation of translucency of monolithic zirconia and framework zirconia materials. J Adv Prosthodont 2016;8:181-6.
  15. Maestre-Ferrin L, Romero-Millan J, Penarrocha-Oltra D, Penarrocha-Diago M. Virtual articulator for the analysis of dental occlusion: an update. Med Oral Patol Oral Cir Bucal 2012;17:e160-3.
  16. Yang S, Dong B, Zhang Q, Li J, Yuan Q, Yue L. An indirect digital technique to transfer 3D printed casts to a mechanical articulator with individual sagittal condylar inclination settings using CBCT and intraoral scans. J Prosthodont 2022;31:822-7.
  17. Abe Hitoshi. The concept of Shilla system and its clinical application. Narae Publishing Inc; 2007. p. 14-6.
  18. Lepidi L, Suriano C, Wang HL, Granata S, Joda T, Li J. Digital fixed complete-arch rehabilitation: From virtual articulator mounting to clinical delivery. J Prosthet Dent 2022;127:398-403.
  19. Reicheneder C, Gedrange T, Baumert U, Faltermeier A, Proff P. Variations in the inclination of the condylar path in children and adults. Angle Orthod 2009;79:958-63.
  20. Hobo S, Shillingburg HT Jr, Whitsett LD. Articulator selection for restorative dentistry. J Prosthet Dent 1976;36:35-43.
  21. Farias-Neto A, Dias AH, de Miranda BF, de Oliveira AR. Face-bow transfer in prosthodontics: a systematic review of the literature. J Oral Rehabil 2013;40:686-92.