DOI QR코드

DOI QR Code

Full mouth rehabilitation with a few remaining teeth and implants for a patient with chronic periodontitis: a case report

만성 치주염 환자에서 소수 잔존치와 임플란트를 이용한 전악 수복: 증례 보고

  • Shin, Eun-Jung (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Vang, Mong-Sook (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Yang, Hong-So (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Park, Sang-Won (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Lim, Hyun-Pil (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Yun, Kwi-Dug (Department of Prosthodontics, School of Dentistry, Chonnam National University)
  • 신은정 (전남대학교 치의학전문대학원 보철학교실) ;
  • 방몽숙 (전남대학교 치의학전문대학원 보철학교실) ;
  • 양홍서 (전남대학교 치의학전문대학원 보철학교실) ;
  • 박상원 (전남대학교 치의학전문대학원 보철학교실) ;
  • 임현필 (전남대학교 치의학전문대학원 보철학교실) ;
  • 윤귀덕 (전남대학교 치의학전문대학원 보철학교실)
  • Received : 2015.06.15
  • Accepted : 2015.07.27
  • Published : 2015.09.30

Abstract

Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients' proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.

만성 치주염 환자 치료시 잔존치 발치 여부를 결정할 때 신중을 기해야 한다. 고정성 또는 가철성 국소의치 치료시 치주조건이 불량한 치아를 지대치로 사용하면 과부하로 조기실패가 우려되어 발치를 고려하지만, 임플란트 고정성 보철물의 경우 잔존치로 전달되는 기능하중을 감소시킬 수 있기 때문에 잔존치를 유지시키는 경우가 많다. 잔존치를 이용한 전악수복시 proprioceptive response를 보존할 수 있어 악간관계와 교합평면 결정시 도움이 될 뿐 아니라 환자의 보철물에 대한 적응이 쉽다. 본 증례의 환자는 치주질환에 의해 다수치 상실 및 대합치의 정출을 보였다. 동요도가 심해 예후가 좋지 않은 치아를 발거하고 소수 잔존치와 임플란트로 전악수복하여 적절한 기능적, 심미적 결과를 얻었다.

Keywords

References

  1. Lundgren D, Nyman S, Heijl L, Carlsson GE. Functional analysis of fixed bridges on abutment teeth with reduced periodontal support. J Oral Rehabil 1975;2:105-16. https://doi.org/10.1111/j.1365-2842.1975.tb01521.x
  2. Nyman S, Lindhe J. A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 1979;50:163-9. https://doi.org/10.1902/jop.1979.50.4.163
  3. Mengel R, Behle M, Flores-de-Jacoby L. Osseointegrated implants in subjects treated for generalized aggressive periodontitis: 10-year results of a prospective, long-term cohort study. J Periodontol 2007;78:2229-37. https://doi.org/10.1902/jop.2007.070201
  4. Hoffmann O, Beaumont C, Zafiropoulos GG. Combined periodontal and implant treatment of a case of aggressive periodontitis. J Oral Implantol 2007;33:288-92. https://doi.org/10.1563/1548-1336(2007)33[288:CPAITO]2.0.CO;2
  5. Ekelund JA, Lindquist LW, Carlssson GE, Jemt T. Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years. Int J Prosthodont 2003;16:602-8.
  6. Attard NJ, Zarb GA. Long-term treatment outcomes in edentulous patients with implant-fixed prostheses: the Toronto study. Int J Prosthodont 2004;17:417-24.
  7. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002;29 Suppl 3):197-212. https://doi.org/10.1034/j.1600-051X.29.s3.12.x
  8. Fransson C, Lekholm U, Jemt T, Berglundh T. Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res 2005;16:440-6. https://doi.org/10.1111/j.1600-0501.2005.01137.x
  9. Roos-Jansaker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol 2006;33:290-5. https://doi.org/10.1111/j.1600-051X.2006.00906.x
  10. Schou S. Implant treatment in periodontitis-susceptible patients: a systematic review. J Oral Rehabil 2008;35 Suppl 1:9-22. https://doi.org/10.1111/j.1365-2842.2007.01830.x
  11. Hugoson A, Laurell L. A prospective longitudinal study on periodontal bone height changes in a Swedish population. J Clin Periodontol 2000;27:665-74. https://doi.org/10.1034/j.1600-051x.2000.027009665.x
  12. Jansson L, Lavstedt S, Zimmerman M. Marginal bone loss and tooth loss in a sample from the County of Stockholm - a longitudinal study over 20 years. Swed Dent J 2002;26:21-9.
  13. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5:347-59.
  14. Laurell L, Lundgren D, Falk H, Hugoson A. Longterm prognosis of extensive polyunit cantilevered fixed partial dentures. J Prosthet Dent 1991;66:545-52. https://doi.org/10.1016/0022-3913(91)90521-W
  15. Nyman S, Ericsson I. The capacity of reduced periodontal tissues to support fixed bridgework. J Clin Periodontol 1982;9:409-14. https://doi.org/10.1111/j.1600-051X.1982.tb02053.x