The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Full mouth rehabilitation through re-establishment of occlusal plane in partially edentulous patient with reduced vertical dimension accompanied by loss of posterior occlusal support

구치부 교합지지 상실과 수직고경 감소를 동반한 부분 무치악 환자에서 교합평면 회복을 통한 완전구강회복 증례

  • Cho, Young Eun (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Leesungbok, Richard (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Lee, Suk Won (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong) ;
  • Choi, Joseph June Sirk (Kyung Hee University School of Dentistry, Department of Biomaterials & Prosthodontics, Kyung Hee University Dental School Hospital at Gangdong)
  • 조영은 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 이성복 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 이석원 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과) ;
  • 최조셉준석 (경희대학교 치과대학, 강동경희대학교병원 치과병원 생체재료보철과)
  • Received : 2022.06.20
  • Accepted : 2022.07.21
  • Published : 2022.07.29
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Abstract

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

구치부 교합지지가 상실되면 수직교합고경이 감소되면서 대합치의 점진적인 정출과 전치부 치아들의 전방 돌출을 초래하게 되고 결국 교합평면이 붕괴됨과 아울러 안모의 변화, 저작 효율 저하, 그리고 측두하악관절 장애 등의 문제가 발생할 수 있다. 이 경우, 정확한 진단 과 예지성 있는 치료계획 수립을 통한 교합평면 재설정 및 수직고경 회복이 필요하다. 본 증례는 71세 여성 환자로, 교합 평면이 붕괴되고 구치부 보철 수복 공간이 부족하여, 수직고경 거상을 동반한 완전구강회복을 계획하였다. 생리적 하악안정위, 연하, 발음, 안모, 전치부 평균 길이 등을 평가하는 임상적 과정을 통해 적절한 수직고경 및 3차원적 교합평면을 재설정하여 임시보철물을 제작하였고, 약 5개월 간 임시 보철물 상태로 악관절 및 저작근의 적응 여부를 관찰하고 교합을 안정화하였다. 기능적, 심미적 임상증상이 없음을 확인한 후 최종 보철 수복하였다. 이러한 환자친화적 완전구강회복 과정을 수행하여 기능 및 심미적으로 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

Keywords

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