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Computer-aided design and manufacturing-based full mouth rehabilitation for a patient with excessive attrition and restricted vertical dimension: A case report

심한 치아 마모와 수복 공간 부족을 보이는 환자에서 CAD/CAM 기술을 활용한 완전 구강 회복: 증례 보고

  • Cho, Jun-Ho (Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Yoon, Hyung-In (Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Yeo, In-Sung (Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Han, Jung-Suk (Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University)
  • 조준호 (서울대학교 치의학대학원 치과보철학교실) ;
  • 윤형인 (서울대학교 치의학대학원 치과보철학교실) ;
  • 여인성 (서울대학교 치의학대학원 치과보철학교실) ;
  • 한중석 (서울대학교 치의학대학원 치과보철학교실)
  • Received : 2019.08.29
  • Accepted : 2019.09.26
  • Published : 2019.10.31

Abstract

This study reported the treatment of a patient with excessive worn dentition and limited maxillo-mandibular space for restoration, utilizing the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. After the thorough examination of the patient's occlusal vertical dimension (OVD), full mouth rehabilitation was planned with increase of the OVD. The patient was satisfied with the provisional restorations establishing the increased OVD. The horizontal and vertical data of the patient's jaw relation that the provisional restorations contained were transferred to the definitive metal ceramic fixed prostheses by double scanning and three-dimensional printing. After the fixed restorations were cemented to the abutments, electronic surveying and three-dimensional printing were used to fabricate metal frameworks for the patient's removable partial dentures. The mandibular definitive removable prostheses were delivered to the patient's mouth and the full mouth rehabilitation procedures were completed. The digital technologies used for this case produced fixed and removable restorations satisfactory in masticatory, phonetic and aesthetic functions to both the patient and the dental clinician.

본 증례는 다수의 치아 상실과 심한 치아 마모로 인해 교합 고경(occlusal vertical dimension)의 감소 및 수복 공간 부족을 보이는 환자에 대한 computer-aided design and computer-aided manufacturing (CAD/CAM) 기술을 활용한 완전 구강 회복 치료이다. 진단 단계에서 교합 고경에 대한 여러 분석을 통해 교합 고경 증가를 통한 완전 구강 회복을 계획하였다. 새롭게 설정된 교합 고경을 반영한 임시 수복물을 환자에게 적용하여 적응시키고, 이중 스캔 방법을 통해 임시 수복물의 정보를 최종 수복물에 옮긴 후, 3D 프린팅을 통해 금속 코핑을 제작하여 최종 고정성 금속 도재 수복물을 완성하였다. 이후 전자 서베잉과 3D 프린팅을 통해 가철성 국소의치 금속 구조물을 제작, 최종 가철성 국소의치로 환자치료를 완료하였다. 이러한 디지털 기술을 활용한 완전 구강 회복 치료로 환자는 기능적, 심미적으로 만족하였고, 술자는 임상적으로 받아들일 만한 치료결과로 판단하였다.

Keywords

References

  1. Al Maaz A, Thompson GA, Drago C, An H, Berzins D. Effect of finish line design and metal alloy on the marginal and internal gaps of selective laser melting printed copings. J Prosthet Dent 2019;122:143-51. https://doi.org/10.1016/j.prosdent.2019.02.009
  2. Wang W, Yu H, Liu Y, Jiang X, Gao B. Trueness analysis of zirconia crowns fabricated with 3-dimensional printing. J Prosthet Dent 2019;121:285-91. https://doi.org/10.1016/j.prosdent.2018.04.012
  3. Arnold C, Hey J, Schweyen R, Setz JM. Accuracy of CAD/CAM-fabricated removable partial dentures. J Prosthet Dent 2018;119:586-92. https://doi.org/10.1016/j.prosdent.2017.04.017
  4. Padwa BL, Kaiser MO, Kaban LB. Occlusal cant in the frontal plane as a reflection of facial asymmetry. J Oral Maxillofac Surg 1997;55:811-6. https://doi.org/10.1016/S0278-2391(97)90338-4
  5. Pinho T, Neves M, Alves C. Multidisciplinary management including periodontics, orthodontics, implants, and prosthetics for an adult. Am J Orthod Dentofacial Orthop 2012;142:235-45. https://doi.org/10.1016/j.ajodo.2010.10.026
  6. Ramfjord SP, Blankenship JR. Increased occlusal vertical dimension in adult monkeys. J Prosthet Dent 1981;45:74-83. https://doi.org/10.1016/0022-3913(81)90015-9
  7. Dawson PE. Functional occlusion: From TMJ to smile design. St Louis; Mosby Elsevier; 2007.
  8. Hemmings KW, Darbar UR, Vaughan S. Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months. J Prosthet Dent 2000;83:287-93. https://doi.org/10.1016/S0022-3913(00)70130-2
  9. Sato S, Hotta TH, Pedrazzi V. Removable occlusal overlay splint in the management of tooth wear: a clinical report. J Prosthet Dent 2000;83:392-5. https://doi.org/10.1016/S0022-3913(00)70032-1
  10. Smith BG, Knight JK. A comparison of patterns of tooth wear with aetiological factors. Br Dent J 1984;157:16-9. https://doi.org/10.1038/sj.bdj.4805401
  11. Shifman A, Laufer BZ, Chweidan H. Posterior bite collapserevisited. J Oral Rehabil 1998;25:376-85. https://doi.org/10.1046/j.1365-2842.1998.00243.x
  12. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1984;52:467-74. https://doi.org/10.1016/0022-3913(84)90326-3
  13. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J 2012;57:2-10. https://doi.org/10.1111/j.1834-7819.2011.01640.x
  14. Karl M, Graef F, Wichmann M, Krafft T. Passivity of fit of CAD/CAM and copy-milled frameworks, veneered frameworks, and anatomically contoured, zirconia ceramic, implantsupported fixed prostheses. J Prosthet Dent 2012;107:232-8. https://doi.org/10.1016/S0022-3913(12)60067-5
  15. Kim SB, Kim NH, Kim JH, Moon HS. Evaluation of the fit of metal copings fabricated using stereolithography. J Prosthet Dent 2018;120:693-8. https://doi.org/10.1016/j.prosdent.2018.01.012
  16. Fathi HM, Al-Masoody AH, El-Ghezawi N, Johnson A. The accuracy of fit of crowns made from wax patterns produced conventionally (hand formed) and via CAD/CAM technology. Eur J Prosthodont Restor Dent 2016;24:10-7.
  17. Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004;15:667-76. https://doi.org/10.1111/j.1600-0501.2004.01120.x
  18. Dawson PE. Determining the determinants of occlusion. Int J Periodontics Restorative Dent 1983;3:8-21.
  19. Proffit WR. Equilibrium theory revisited: factors influencing position of the teeth. Angle Orthod 1978;48:175-86.
  20. Carlsson GE, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth. J Prosthet Dent 1979;41:284-9. https://doi.org/10.1016/0022-3913(79)90008-8