Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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Occlusal rehabilitation of post-traumatic malocclusion patient after reduction of panfacial fracture, using selective occlusal adjustment and implant prostheses on centric relation: a case report

다발성 안면 골절의 정복 후 발생한 부정교합 상태의 환자를 중심위에서 선택적 교합 조정 및 임플란트 보철수복으로 교합관계를 회복시킨 증례

  • Dae-Kyun Kim (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National university - Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • So-Young Park (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National university - Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Jung-Jin Lee (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National university - Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Yeon-Hee Park (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National university - Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Kyoung-A Kim (Department of Dentistry, Daejeon Konyang Medical Center, Konyang University, School of Medicine) ;
  • Jae-Min Seo (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National university - Biomedical Research Institute of Jeonbuk National University Hospital)
  • 김대균 (전북대학교 치의학전문대학원 치과보철학교실, 전북대학교병원 의생명연구원) ;
  • 박소영 (전북대학교 치의학전문대학원 치과보철학교실, 전북대학교병원 의생명연구원) ;
  • 이정진 (전북대학교 치의학전문대학원 치과보철학교실, 전북대학교병원 의생명연구원) ;
  • 박연희 (전북대학교 치의학전문대학원 치과보철학교실, 전북대학교병원 의생명연구원) ;
  • 김경아 (건양대학교 의과대학 치과학교실) ;
  • 서재민 (전북대학교 치의학전문대학원 치과보철학교실, 전북대학교병원 의생명연구원)
  • Received : 2023.08.24
  • Accepted : 2023.09.22
  • Published : 2023.12.31
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Abstract

Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.

구강 악안면 영역에서 외상으로 인해 발생한 골절에 대한 치료로 관혈적 혹은 비관혈적인 골절의 정복을 시행할 수 있다. 그러나, 최적의 정복이 이루어지지 않았거나 부정 유합이 발생할 경우, 하악골과 중안모 간의 구조적 관계가 상실되어 부정교합이 일어날 수 있다. 이러한 부정교합은 외상 후 부정교합이라 정의되며 안정적인 턱관절 위치의 확보 후 악교정 수술, 교정치료, 교합 재형성 및 보철적 재건 등이 외상 후 부정교합의 치료방법으로 제시되고 있다. 안정적인 턱관절은 교합 회복 전 부정교합의 재발 및 교합 변화를 방지하기 위해 필수적이며, 중심위 및 적응된 중심위는 가장 안정적인 턱관절의 위치로 교합 회복의 시작점이다. 본 증례는 다발성 안면 골절의 정복 후, 외상 후 부정교합이 발생하여 전악 교합의 회복을 위해 중심위에서 선택적 교합 조정 및 임플란트 지지 고정성 보철물로 보철적 재건을 시행한 증례로 교합 기능적으로 양호한 결과를 얻었기에 이를 보고하고자 한다.

Keywords

References

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