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악교정 수술을 동반한 임플란트 보철물을 이용한 완전구강회복 증례
Full-mouth rehabilitation by immediate implantation combined with orthognathic surgery: a clinical report 원문보기

대한치과보철학회지 = The journal of Korean academy of prosthodontics, v.54 no.1, 2016년, pp.57 - 64  

안혜림 (동아대학교 의료원 치과보철학교실) ,  허지예 (동아대학교 의료원 치과보철학교실) ,  김철훈 (동아대학교 의료원 구강악안면외과학교실) ,  황희성 (동아대학교 의료원 치과보철학교실) ,  김복주 (동아대학교 의료원 구강악안면외과학교실)

초록
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악교정 수술과 임플란트 보철을 통한 전악재건술의 임상적 치료는 보철과 의사에게 도전적인 과제이다. 본 증례는 골격적 부조화를 가진 다발성 우식증 환자의 진단과 치료에 있어서 치의학의 여러 분야의 협진을 보여주었다. 그 결과로 악교정 수술을 동반한 발치 후 즉시 임플란트 식립 및 조기 하중을 가하는 임플란트 보철물에 의한 전악 재건이 예견가능하고 효과적인 치료 방법이었기에 이를 보고하고자 한다.

Abstract AI-Helper 아이콘AI-Helper

Clinical therapy that combines full-mouth rehabilitation with immediate implantation and orthognathic surgery poses a challenge to prosthodontists. This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient presenting with skeletal discrepancy and rampant...

주제어

AI 본문요약
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제안 방법

  • At one month after orthognathic surgery, all of the mandibular teeth were extracted and 7 dental implants (s-clean Tapered II; Dentis, Seoul, Korea) were immediately inserted into the #34, 35, 37, 41, 44, 45 and 46 extraction sockets. At the #33 and 43 extraction sites, because primary stability had not been achieved, socket preservation was performed as a preparation to the planned delayed implant placement.
  • A 40-year-old male visited the Department of Oral and Maxillofacial Surgery, Dong-A University Medical Center, Busan, South Korea, in 2012. His chief complaint was multiple dental caries with anterior crossbite. He was subsequently referred to the Department of Prosthodontics for full-mouth rehabilitation.
  • One week after implantation in the mandible, both maxillary and mandibular impressions for the provisional restoration were formed in polyvinyl siloxane material (ImprintTM II GarantTM; 3M ESPE, St. Paul, MN, USA) using a custom impression tray. The occlusal rim was fabricated on a working cast.
  • Therefore, provisional prostheses were used to facilitate fabrication of the definitive restorations, to which end, mandibular final impressions were formed in polyvinyl siloxane material, and a customized anterior guidance table was established. The CR record was made between the anterior customized abutment using polyvinyl siloxane (O-Bite TM; DMG, Hamburg, Germany), while the posterior provisional restorations were kept in place to maintain the occlusal vertical dimension. Another CR record was made, in a similar manner, between the posterior abutments.
  • Using the putty index of the wax-up, provisional restorations also were made. The customized abutment was installed and tightened to 25 Ncm, the provisional restorations were cemented (TempBond; Kerr, Romulus, MI, USA), and occlusal adjustment was performed (Fig. 5).
  • One week later, provisional fixed prosthodontic restorations were fabricated. The final surgical treatment objective (STO) for the BSSRO was planned on the basis of these provisional restorations, and BSSRO was performed under general anesthesia. The class I relationship was achieved by setback positioning of the mandible.
  • The objectives of this case report are to evaluate short term success of a patient presenting with skeletal discrepancy and multiple caries that treated with full-mouth rehabilitation by immediate implantation combined with socket elevation and orthognathic surgery. The patient’s diagnosis, treatment planning, total treatment period and the achieved 1-year stability are described herein.
  • The patient, with his delivered provisional restorations at the corrected vertical dimension, had no temporomandibular disorder (TMD), pronunciation or deglutition problems for 2 months. Therefore, provisional prostheses were used to facilitate fabrication of the definitive restorations, to which end, mandibular final impressions were formed in polyvinyl siloxane material, and a customized anterior guidance table was established.
  • Another CR record was made, in a similar manner, between the posterior abutments. This assembly was then remounted, and the definitive restorations were fabricated, according to the custom incisal guide table, as the cemented type for the anterior area and the screw-cemented-retained prostheses (SCRP) type for the posterior area. The definitive prostheses were cemented with resin (PremierTM Implant CementTM; Premier Co.

대상 데이터

  • A 40-year-old male visited the Department of Oral and Maxillofacial Surgery, Dong-A University Medical Center, Busan, South Korea, in 2012. His chief complaint was multiple dental caries with anterior crossbite.
  • Five months after socket preservation, dental implants (s-clean Tapered II; Dentis, Seoul, Korea) were inserted at the #33 and 43 sites.
본문요약 정보가 도움이 되었나요?

참고문헌 (20)

  1. Ravindran DM, Sudhakar U, Ramakrishnan T, Ambalavanan N. The efficacy of flapless implant surgery on soft-tissue profile comparing immediate loading implants to delayed loading implants: A comparative clinical study. J Indian Soc Periodontol 2010;14:245-51. 

  2. Williams AC, Shah H, Sandy JR, Travess HC. Patients' motivations for treatment and their experiences of orthodontic preparation for orthognathic surgery. J Orthod 2005;32:191-202. 

  3. Janson M, Janson G, Sant'Ana E, Tibola D, Martins DR. Orthognathic treatment for a patient with Class III malocclusion and surgically restricted mandible. Am J Orthod Dentofacial Orthop 2009;136:290-8. 

  4. Lindeboom JA, Tjiook Y, Kroon FH. Immediate placement of implants in periapical infected sites: a prospective randomized study in 50 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:705-10. 

  5. Degidi M, Piattelli A, Carinci F. Immediate loaded dental implants: comparison between fixtures inserted in postextractive and healed bone sites. J Craniofac Surg 2007;18:965-71. 

  6. Pieri F, Aldini NN, Fini M, Corinaldesi G. Immediate occlusal loading of immediately placed implants supporting fixed restorations in completely edentulous arches: a 1-year prospective pilot study. J Periodontol 2009;80:411-21. 

  7. Raes F, Cooper LF, Tarrida LG, Vandromme H, De Bruyn H. A case-control study assessing oral-health-related quality of life after immediately loaded single implants in healed alveolar ridges or extraction sockets. Clin Oral Implants Res 2012;23:602-8. 

  8. Meizi E, Meir M, Laster Z. New-design dental implants: a 1-year prospective clinical study of 344 consecutively placed implants comparing immediate loading versus delayed loading and flapless versus full-thickness flap. Int J Oral Maxillofac Implants 2014;29:e14-21. 

  9. Chrcanovic BR, Albrektsson T, Wennerberg A. Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis. Int J Oral Maxillofac Surg 2015;44:493-506. 

  10. Robling AG, Turner CH. Mechanical signaling for bone modeling and remodeling. Crit Rev Eukaryot Gene Expr 2009;19:319-38. 

  11. Wang HL, Boyapati L. "PASS" principles for predictable bone regeneration. Implant Dent 2006;15:8-17. 

  12. Vogl S, Stopper M, Hof M, Wegscheider WA, Lorenzoni M. Immediate Occlusal versus Non-Occlusal Loading of Implants: A Randomized Clinical Pilot Study. Clin Implant Dent Relat Res 2015;17:589-97. 

  13. Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res 2012;23:39-66. 

  14. Tomasi C, Sanz M, Cecchinato D, Pjetursson B, Ferrus J, Lang NP, Lindhe J. Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis. Clin Oral Implants Res 2010;21:30-6. 

  15. Calvo-Guirado JL, Boquete-Castro A, Negri B, Delgado Ruiz R, Go′mez-Moreno G, Iezzi G. Crestal bone reactions to immediate implants placed at different levels in relation to crestal bone. A pilot study in Foxhound dogs. Clin Oral Implants Res 2014;25:344-51. 

  16. Caneva M, Salata LA, de Souza SS, Baffone G, Lang NP, Botticelli D. Influence of implant positioning in extraction sockets on osseointegration: histomorphometric analyses in dogs. Clin Oral Implants Res 2010;21:43-9. 

  17. De Rouck T, Collys K, Cosyn J. Single-tooth replacement in the anterior maxilla by means of immediate implantation and provisionalization: a review. Int J Oral Maxillofac Implants 2008;23:897-904. 

  18. Kobayashi T, Watanabe I, Ueda K, Nakajima T. Stability of the mandible after sagittal ramus osteotomy for correction of prognathism. J Oral Maxillofac Surg 1986;44:693-7. 

  19. Proffit WR, Phillips C, Dann C 4th, Turvey TA. Stability after surgical-orthodontic correction of skeletal Class III malocclusion. I. Mandibular setback. Int J Adult Orthodon Orthognath Surg 1991;6:7-18. 

  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. 

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