심하게 위축된 하악골의 완전 무치악 환자에서의 수직 골신장술을 이용한 임플란트 치료

IMPLANT INSTALLATION USING VERTICAL DISTRACTION OSTEOGENESIS AT A SEVERELY ATROPHIED EDENTULOUS MANDIBLE

  • 염학렬 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 전승호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김윤태 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 팽준영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 안강민 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 명훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 황순정 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 서병무 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 최진영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 정필훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실)
  • Yeom, Hak-Ryol (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Jeon, Seung-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Yoon-Tae (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Paeng, Jun-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Ahn, Kang-Min (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Myung, Hoon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Hwang, Soon-Jung (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Seo, Byoung-Moo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Choi, Jin-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Choung, Pill-Hoon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University)
  • 발행 : 2006.03.31

초록

Objectives : It is difficult to place implants at a severely atrophied edentulous mandible because of vertical and horizontal alveolar defect. The autogenous and allogenic bone graft and guided bone regeneration are useful, but there are some limitations such as the resorption and infection of the grafted bone, and insufficiency of soft tissue. Distraction osteogenesis has recently evolved a challenging technique to overcome major draws of conventional augmentation procedures, we, therefore, report the four applications of implant placement after vertical alveolar distraction osteogenesis. Patients and Methods : Four patients(all female, mean age: $60{\pm}6$ years) with severe alveolar ridge deficiencies at their anterior mandible were treated with vertical alveolar distraction osteogenesis by intraoral device(Track 1.5, 15 mm model, KLS Martin, Tuttlingen, Germany) and placement of implants (Branemark MK III, TiUnite). After the latency periods of 5, 7, 8 days, distraction rhythm and rate were $0.5\;mm{\times}2\;times/day$ in the case of good bone quality, and $0.25\;mm{\times}3\;times/day$ in the case of poor bone quality. After consolidation periods of mean fifteen weeks, five implants for each patients were placed at the interforaminal area. Results : On average, a vertical gain of $11.38{\pm}1.38\;mm$ was obtained by distraction. And all distraction zone showed complete ossification by panoramic radiography. There were no postoperative complications other than numbness of lower lip in one case. Total twenty implants in four patients were placed and their outcomes were satisfactory. Conclusion : It is a useful method to place five implants after vertical distraction osteogenesis of the severely atrophied mandible for the implant-supported fixed prosthesis.

키워드

참고문헌

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