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가성 3급 부정교합에서 중심위에 맞는 치아 및 임플란트 보철 수복으로 교합관계 개선 증례 보고

Prosthetic rehabilitation of pseudo-Class III malocclusion using tooth- and implant-supported prosthetic restoration in centric relation (CR): a case report

  • 투고 : 2025.04.27
  • 심사 : 2025.07.24
  • 발행 : 2025.08.31

초록

이 증례 보고에서는 안정적인 치아의 정지 및 지지의 결핍으로 불안정한 하악 운동을 보이는 가성 3급 부정교합을 가진 환자의 고정성 보철수복을 소개한다. 후방 지지가 없는 상태에서 환자는 중심위 관계로의 유도 중 상악 절치의 순면을 따라 하악 절치가 미끄러지며 하악이 전상방으로 이동했다. 이에 환자는 자발적인 폐구에서 하악이 습관적으로 전상방으로 움직이는 양상을 보였다. 치료를 위해 먼저 중심위에 맞는 전치부 정지를 형성하였고, 구치부는 임플란트 식립 후임시치아를 이용하여 즉시부하를 주어 구치부 지지를 얻었다. 치아의 안정적인 정지 및 지지를 통해 환자는 술자가 재현한 중심위에 맞추어 안정적으로 저작을 할 수 있었다. 이 증례를 통해, 안정적인 치아 지지가 없어 가성 3급 부정교합을 가진 환자에서 올바른 치아의 지지를 형성해 주었을 때 중심위에 맞는 안정적인 저작이 가능함을 확인하였다.

This report presents the management of a patient with pseudo Class III malocclusion and unstable mandibular movements caused by the lack of a stable occlusal stop. Without posterior support, the mandibular incisors slid along the labial surfaces of the maxillary incisors during centric relation (CR) guidance, resulting in anterior mandibular closure. This pattern presented as a habitual antero-superior mandibular displacement during voluntary closure. Provisional prostheses for the maxillary anterior teeth and mandibular posterior implants were concurrently positioned in the appropriate CR position. Following the immediate establishment of a stable stop for proper CR, stable mastication in this position was achieved. The findings suggest that the patients with unstable CR guidance due to insufficient occlusal stabilization can attain immediate functional stability through a reliable teeth stop in the corrected CR position.

키워드

과제정보

This study is supported by Cheongju Seoul Good Dental Hospital in 2025.

참고문헌

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