심한 치아 마모와 수복공간 부족을 보이는 환자에서의 완전 구강회복 증례 = Full mouth rehabilitation of the patient with severely worn dentition and limited vertical dimension

다국어 초록 (Multilingual Abstract)

Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient’s adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

국문 초록 (Abstract)

심한 치아 마모는 치료되지 않고 방치될 경우에 치아 구조물의 상실, 치수 합병증, 착색, 기능과 심미의 상실과 같은 여러 합병증 등을 야기한다. 본 증례의 환자는 전치부에서 특히 심한 치아마모를 보이며 수복공간 부족을 보이는 경우로 수직고경 거상을 동반한 전악 고정성 보철물로 수복을 하였다. 진단납형을 토대로 수직거상량을 결정하고 가철성 교합안정장치를 6주간 장착하여 적응도를 평가하였다. 이후 고정성 임시보철물을 수복함으로써 3달간 근신경계의 조화, 심미, 측두하악관절 등에 대하여 재평가하였다. 위와 같은 치료과정을 통해서 단일구조 지르코니아를 이용한 전악 고정성 보철물로 최종수복을 완료하였고 기능적, 심미적으로 안정적인 결과를 얻었기에 보고하는 바이다.

참고문헌 (Reference)

1 Mörmann WH, "Wear characteristics of current aesthetic dental restorative CAD/CAM materials : twobody wear, gloss retention, roughness and Martens hardness" 20 : 113-125, 2013

2 Muts EJ, "Tooth wear : a systematic review of treatment options" 112 : 752-759, 2014

3 Kwon KR, "The prosthetic approach for collapsed vertical dimensions of occlusion" 20 : 169-181, 2004

4 Turner KA, "Restoration of the extremely worn dentition" 52 : 467-474, 1984

5 Rivera-Morales WC, "Relationship of occlusal vertical dimension to the health of the masticatory system" 65 : 547-553, 1991

6 Ilie N, "Quantification of the amount of light passing through zirconia : the effect of material shade, thickness, and curing conditions" 42 : 684-690, 2014

7 Solá-Ruiz MF, "Prospective study of monolithic zirconia crowns : clinical behavior and survival rate at a 5-year follow-up" 65 : 284-290, 2021

8 Roediger M, "Prospective evaluation of zirconia posterior fixed partial dentures : four-year clinical results" 23 : 141-148, 2010

9 Ramfjord SP, "Increased occlusal vertical dimension in adult monkeys" 45 : 74-83, 1981

10 Johansson A, "Identification and management of tooth wear" 7 : 506-516, 1994

11 Dawson PE, "Functional occlusion: From TMJ to smile design" Mosby Elsevier 430-452, 2007

12 Hayashi M, "Fracture resistance of pulpless teeth restored with postcores and crowns" 22 : 477-485, 2006

13 Zesewitz TF, "Fracture resistance of a selection of full-contour all-ceramic crowns : an in vitro study" 27 : 264-266, 2014

14 Kaiser DA, "Fabricating a customized incisal guide table" 45 : 568-569, 1981

15 Carlsson GE, "Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth" 41 : 284-289, 1979

16 Miyazaki T, "Current status of zirconia restoration" 57 : 236-261, 2013

17 Abduo J, "Clinical considerations for increasing occlusal vertical dimension : a review" 57 : 2-10, 2012

18 Sirimai S, "An in vitro study of the fracture resistance and the incidence ofvertical root fracture of pulpless teeth restored with six post-and-coresystems" 81 : 262-269, 1999

19 Gopi Chander N, "An appraisal on increasing the occlusal vertical dimension in full occlusal rehabilitation and its outcome" 11 : 77-81, 2011

20 Gross MD, "A preliminary study on the effect of occlusal vertical dimension increase on mandibular postural rest position" 7 : 216-226, 1994