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상악골 부분 절제술을 받은 무치악 환자에서의 구강폐쇄장치 수복
Prosthetic rehabilitation using an obturator in a fully edentulous patient who had partial maxillectomy
J Dent Rehabil Appl Sci 2018;34(4):331-337
Published online December 31, 2018
© 2018 Korean Academy of Stomatognathic Function and Occlusion.

정유진1, 김종진1, 백 진1, 차현석2, 이주희2*
Yoo-Jin Chung1, Jong-Jin Kim1, Jin Baik1, Hyun-Suk Cha2, Joo-Hee Lee2*

1서울아산병원 치과보철과
2울산대학교 의과대학 서울아산병원 치과보철학교실

1Divison of Prosthodontics, Department of Dentistry, Asan Medical Center, Seoul, Republic of Korea
2Divison of Prosthodontics, Department of Dentistry, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
Joo-Hee Lee
Professor, Division of Prosthodontics, Department of Dentistry, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea, Tel: +82-2-3010-3850, Fax: +82-2-3010-6967, E-mail: ljhl11911@hanmail.net
Received August 6, 2018; Revised August 20, 2018; Accepted August 23, 2018.
Abstract
상악골 결손을 갖고 있는 무치악 환자를 폐쇄장치로 수복할 때 임상가들은 많은 어려움을 겪게 된다. 결손부를 통한 공기의 누출, 안정성과 지지의 부족, 감소된 의치 피개 면적은 의치의 흡착과 변연 폐쇄를 어렵게 한다. 본 증례는 편평상피암에 이환된 우측 상악동 부위에 상악골 절제술을 받은 무치악 환자로 술전 치과 검진, 수술용 폐쇄장치, 이행 폐쇄장치, 그리고 최종 폐쇄장치에 이르는 단계적 치료 과정을 통해 보철적 재건을 완료하였다. 본 증례의 환자는 전상악골 및 양측 상악 결절이 온전하며 한정된 크기의 결손부를 가져 적절한 유지와 지지를 갖는 폐쇄장치를 제작할 수 있었으며 심미 및 기능면에서 양호한 예후를 보였기에 이를 보고하는 바이다.
Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.
주요어 : 주요어: 구강암; 상악골 절제술; 폐쇄장치; 완전 무치악
Keywords : Key words: oral cancer; maxillectomy; obturator; complete edentulous


December 2018, 34 (4)
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