디지털 식립 가이드와 주모형상의 연조직 모델링을 활용한 상악 전치부 임플란트의 심미적 수복: 3 증례 보고
Esthetic restoration of the maxillary anterior implant by digital surgical guide and soft tissue modeling on the master cast: Report of 3 cases
이성근,
소속 상세정보
이성근 ( Lee Seong-Geun ) - Lee Seong Geun Dental Clinic
KMID : 1033920210170020062
Abstract
Aim: The elderly has a vague anxiety and fear in implant surgery and complains suffering from exaggerated gag reflex due to pooled water and excess impression materials in the oropharynx. Considering these problems, this was to report simple fabrication of a hygienic and esthetic crown of the maxillary anterior implant by digital surgical guide (DSG)-aided implant placement, impression taking, alteration of a study model to the master cast and soft tissue modeling.
Methods: Preoperatively, patient’s study model was sent to digital center of implant company, uploading panoramic view and cone beam computed tomography (CBCT) data. DSG was fabricated with digital planning of three-dimensional location, diameter and length of dental implant. After DSG was seated in the intraoral site, dental implant was installed by guided surgery kit as a minimally invasive mode. With inlay pattern resin, DSG was bonded to impression coping which was connected to dental implant placed. Laboratory analog(LA) was connected to the incorporated DSG-impression coping. Study model was altered to the master cast, with cutting and re-pouring of stone around LA. The emergence profile of temporary abutment crown (TAC) was completed by adding the acrylic resin on the master cast and in the oral site. Introral rubber impression was taken in limited TAC area by partial metal tray to avoid gag reflex and separated from the partial tray for passive seating of TAC. After TAC was inserted into impression site, it was marked along the subgingival line of TAC by the pencil. Soft tissue modeling was completed, syringing Perfect-F Light(vinyl poly siloxane) around a subgingival line of TAC on the master cast. With gingival sculpturing along a subgingival line of TAC, CAD/CAM abutment and esthetic final crown of implant were fabricated.
Case Report: In 3 patients showing severe mobility of #22 in female patient of 68 years old, severe agitation of #21 in male patient of 66 years old and frequent displacement of #13 post & core crown in female patient of 74 years old, a hygienic and esthetic outcome was obtained according to the method described the above.
Conclusion: In the anxious elderly with exaggerated gag reflex during the implant procedure, it is feasible to fabricate a hygienic and esthetic restoration by DSG-aided implant placement, impression taking, alteration of a study model to the master cast and soft tissue modeling on the master cast
키워드
Digital surgical guide; Emergency profile; Minimally invasive; Study model alteration
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