Abstract
Mini-dental implants for overdenture applications are increasingly popular due to their ease in placement with simplified, less traumatic surgical protocols in limited-width alveolar ridges. However, the clinical decisions including implant number, position, and loading protocol must be based on a thorough evaluation and evidence-based diagnosis. Herein, we reported a case treated with the current method of mandibular mini-implant supported overdenture.
Key Words: case report, denture, edentulous, mini-dental implants, overdenture
Ⰻ⨸⺤ㄦ⬚コ⮇⺝ㄴㄲⷜ⺘⺤ㄦ⬚コ⼥⼥ㄪ⢤⺘
⼤⭍ⱕ⣞
Ⱉ⼧ㅬ⺝⻓⸠ⳮ⹂
고려대학교 임상치의학대학원 고급치과보철학교실, 임상치의학연구소
Mandibular Mini-Implants Supported Overdentures: A Case Report
Jin-Hong Park, Jeong-Yol Lee, Sang-Wan Shin
Department of Prosthodontics, Institute for Clinical Dental Research, Korea University Medical Center, Seoul, Korea
ISSN 1229-5418 Implantology 2015; 19(3): 146~152
Reprint requests: Jeong-Yol Lee
Department of Prosthodontics, Institute of Clinical Dental Research, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: 82-2-2626-1922, Fax: 82-2-866-1499
E-mail: [email protected] Received for publication: July 1, 2015 Revised for publication: July 8, 2015 Accepted for publication: July 15, 2015
교신저자: 이정열
(08308) 서울시 구로구 구로동로 148
고려대학교구로병원 치과보철과, 임상치의학연구소 Tel: 82-2-2626-1922, Fax: 82-2-866-1499 E-mail: [email protected]
원고접수일: 2015년 7월 1일 원고수정일: 2015년 7월 8일 게재확정일: 2015년 7월 15일
Copyright © 2015. The Korean Academy of Oral & Maxillofacial Implantology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ᕽᅙ᷾ಡᅕŁᨱᕽ۵⦹ᦦ᮹ᦩᱥྕ⊹ᦦ⪹ᯱᨱ ᕽၙܩᯥ⥭✙ෝᯕᬊ⦽⦝}᮹⊹᷾ಡෝᗭ}⦹Ł bŝᱶᨱෙŁಅᔍ⧎ᨱݡ⦽᷾Ñෝᱽ⧕ᅕŁᯱ
⦽݅
** 증례보고
ᖙԉᯱ⪹ᯱaʑ᳕᮹⊹᮹ᮁḡಆᇩపᮥᵝᗭಽ
Łಅݡ⦺ƱǍಽᄲᬱᨱԕᬱ⦹ᩡ݅⪹ᯱ᮹ᄲಆ᳑ᔍᨱ ᕽݚىa⪶ᯙࡹᨩᮝ໑ ᯥᔢၰႊᔍᖁáᔍđŝᔢ⦹
ᦦ᪥ᱥྕ⊹ᦦᔢ┽ಽ 'JH_ ʑ᳕᮹⊹۵ᄡᩑ⩶ᖒ
ၰԕ໕ᱢ⧊ࠥaᇩప⦹ᩍ☖ჶᨱᔢ⦹ⅾ᮹⊹ෝ
ᰍᱽ᯲⦹ᩡ݅⦹ḡอᙹ}ᬵ࠺ᦩᔩಽᱽ᯲ࡽ᮹⊹ᨱ
ᖒŖᱢᮝಽᱢ᮲⦹ḡ༜⦹ᩍ⦹ᦦ᮹ᯥ⥭✙ḡḡ⦝}
⦹ᦦ᪥ᱥྕ⊹ᦦ⪹ᯱᨱᕽ}᮹ᯥ⥭✙ෝᯕ ᬊ⦽ᯥ⥭✙⦝}᮹⊹⊹ഭ۵᮹⊹᮹ᮁḡ
᪡ᦩᱶᮥ⨆ᔢ⍽⬉ŝᱢᯕ໑aᰆᩩḡᖒ
ᯩ۵⊹ഭᵲ⦹ӹಽᩍĉḡŁᯩ݅⦹ḡอᯥ⥭✙
⊹ഭ۵᳕ʼn᮹᧲ᯕ∊ᇥ⦹ḡᦫᮡĞᬑ ⪹ᯱ᮹ᱥᝁ Õvᔢ┽ ᙹᚁᨱݡ⦽Ŗ⡍॒᮹ᯕᮁಽভভಽᱽ⦽ᱢ ᯙ⊹ഭaࢁᙹၷᨱᨧ݅
ၙܩᯥ⥭✙۵ྕᱩ}ಽพa܆⦹ᩍ⊹ᮁʑeᯕ
ṈŁᚁ⬥⪹ᯱ᮹ᇩ⠙qᮥ↽ᗭ⪵┍ᙹᯩ݅۵ᰆᱱ ᯕᯩᨕ✚⯩Łಚ᮹ྕ⊹ᦦ⪹ᯱᨱᕽᳬᮡ⊹ഭݡᦩᯕ
ࢁᙹᯩ݅#JESB᪡"MNBT۵ၙܩᯥ⥭✙᮹ᔾ᳕
ᮉᨱݡ⦽TZTUFNBUJDSFWJFXᨱᕽⅩʑ֥eၙܩᯥ⥭
✙᮹ᔾ᳕ᮉᮡಽ⢽ᵡḢĞᯥ⥭✙᮹ᖒŖශ ŝእ⦹݅Ł⦹ᩡ݅ᐱอᦥܩၙܩᯥ⥭✙ෝᯕ ᬊ⦽⦹ᦦ᮹᪅ქߕᨱݡ⦽ᯥᔢᩑǍᨱ໕ ⠪Ɂ
⠪aʑe ↽ݡ ֥ ࠺ᦩ ၙܩ ᯥ⥭✙᮹ ᔾ᳕ᮉᮡ
Fig. 1. Intra oral photo; maxilla.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
Fig. 2. Intra oral photo; mandible.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
Case Report
᮹⊹ಽᱥ⪹⧁äᮥĥ⫮⦹ᩡ݅݉ ᇩ∊ᇥ⦽᳕⊹᳑
ʼn᧲ŝᱥᝁᱢᯙÕvᔢ┽ၰŝᱢᙹᚁᨱݡ⧕ࢱಅ ᬭ⦹۵ᝍญᔢ┽ෝŁಅ⦹ᩍ⦹ᦦ᮹ၙܩᯥ⥭✙ḡḡ
᪅ქߕෝĥ⫮⦹ᩡ݅
⦹ᦦ᮹᳕⊹᳑ʼnᮡၽ⊹⬥ᙹ}ᬵᯕḡӹᦩᱶࡽ
ᔢ┽ಽ∊ᇥ⦽b⪵⊹ᮡᮥaḡ໑ ᵲ᷾ࠥ᮹⊹᳑ʼnᗭ ᝅᮥӹ┡ԕᨩ݅ੱ⦽⦹ᦦ᮹⊹۵᮹⊹ԕ໕⊹᳑ᱶᨱ ᕽ⦹ᦦᱥ⊹ᇡᱩ݉ᩑʭḡNNಽ⦹ᦦ᮹ၙܩᯥ⥭
✙᪅ქߕෝ⧪⦹۵ߑ∊ᇥ⦽ŖeᮥaḡŁᯩᨩ
݅$POFCFBNDPNQVUFEUPNPHSBQIZၰQBOPSBNBෝ
ᯕᬊ⦽ႊᔍᖁᱢḥ݉đŝⰜNN.%* .&41&
4U1BVM ./ 64"}ෝᯕŖᔍᯕᨱɁ॒⯩႑ᇥ⦹ᩍ
พ⦹ʑಽ⧩݅ 'JHᙹᚁᮡ⧕ݚᇡ⋉ᮅษ≉⦹ᨱ
ྕᱩ}ಽ พ⦹ᩡᮝ໑ 'JH Ⅹʑ พ ☁Ⓧ۵
_/DNෝӹ┡ԕᨕ᮹⊹ԕ໕Ŗe⪶ᅕ⬥ᩑḩ᮹⊹
ᯕᰆᱽ $PF4PGU ($"NFSJDB "MTJQ *- 64"ෝᯕᬊ
⦹ᩍᯕᰆ⦹ᩡ݅ 'JH⪹ᯱ۵ᚁ⬥᮹⊹ෝ↽ᗭ⦽ᮝ ಽ₊ᬊ⦹ࡹᮭྜྷᖎ≉ၹऽ᮹⊹ෝᔍᬊ⦹ࠥಾ
Ʊᮂ⦹ᩡ݅
ᯥ⥭✙ พ ᵝ ⬥ ၙܩ ᯥ⥭✙᮹ ࠺ࠥෝ
1FSJPUFTU. .FEJ[JOUFDIOJL(VMEFO .PEBVUBM (FS
NBOZᮥᯕᬊ⦹ᩍ⠪a⬥ǍvԕḢᱲჶᮝಽၙܩᅝ ᨕ┽⊹ຝ✙ CBMMBUUBDINFOU᮹NBUSJYෝᩑđ⦹ᩡᮝ໑ 'JH ᱶʑᱢᯙԕᬱ⦹ᨱᮁḡšญෝḥ⧪⦹Łᯩ݅
*** 총괄 및 고찰
↽ɝ,FSO॒᮹TZTUFNBUJDSFWJFXᨱ໕⦹ᦦ᮹
ᯥ⥭✙᪅ქߕᨱᕽ}᮹ᯥ⥭✙ෝพ⦽Ǒᨱ ᕽ}ᅕ݅ʑ܆⬥ᯥ⥭✙ᔾ᳕ᮉᯕԏᦹᮭᯕᅕŁ
ࡽၵᯩḡอ ᩍᱥ⯩⦹ᦦ᮹ᯥ⥭✙ḡḡ⦝}᮹⊹᮹
ᬱ⊺ᮡ}ᯥ⥭✙Ł⧁ᙹᯩ݅⦹ḡอ⩥ᰍʭḡ
ၙܩᯥ⥭✙ᙹᨱݡ⦽⧊᮹۵ᯕᨕḥၵaᨧᮝ໑
4.7 mm
15.1 mm
4.1 mm 4.4 mm 4.7 mm
15.1 mm
15.1 mm 15.4 mm
Fig. 4. Computed tomography and panorama view for implant diagnosis.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
Fig. 3. Panoramic view.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report Implantology 2015
D E F
Fig. 5. (A) Adaptation of surgical stent. (B) Intra-oral photo before implant insertion. (C) Drilling. (D) Implant insertion. (E) Intra-oral photo after implant insertion. (F) Periapical X-ray after implant insertion.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
A B C
D E F
Fig. 6. (A) Checking of implant position. (B, C) Relief of denture base. (D, E) Application of soft denture re-lining material (Coe-Soft; GC America, Alsip, IL, USA). (F) Inner side of relined denture.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
Case Report
ḡɩʭḡᅕŁࡽᩑǍॅ᮹ᯥ⥭✙ᔾ᳕ᮉᨱ໕
}᪡}༉ࢱᨱᕽอ᳒⧁อ⦽đŝෝᅕᯕŁᯩ݅
݉ +PGSé॒᮹ᩑǍđŝ۵ࢱ}᮹ၙܩᯥ⥭✙ෝ
CBSಽTQMJOUෝ⧪⦽ᩑǍෝ⡍⧉⦹ŁᯩŁ 4FOEBY۵
ၙܩᯥ⥭✙᮹ᰆʑᱢᯙᔾ᳕ᮉᨱݡ⦽ᱶᅕᇡ᳒ŝ
SFHVMBSJNQMBOUᨱእ⧕ԏᮡʑĥᱢᖒḩ॒ᮥᯕᮁಽ
}᮹ၙܩᯥ⥭✙ෝพ⧁äᮥ⇵⦹Łᯩᮝအಽ
ᯕᨱݡ⦽ᵝ᮹ʫᮡŁಅa⦥⦹݅
ᯥ⥭✙᮹พ᭥⊹ᨱݡ⦽⧊᮹ੱ⦽ᯕᨕḥၵ
ᨧᯕ4FOEBY۵᧲⊂ᯕŖᨱᕽNNᱥႊ᭥⊹ᨱ}᮹
ᯥ⥭✙ෝพ⦽⬥ӹນḡࢱ}۵ᱥႊ_NNᨱ
พ⧁äᮥ⇵⦹ᩡŁ &MTZBE॒ᮡč⊹᪡ᱽᗭǍ⊹
᭥⊹ᨱพ⧁äᮥ -FF॒ᮡᯕŖᱥႊᇡᨱ}᮹ၙ
ܩᯥ⥭✙ෝ↽ݡ⦽ᇥᔑ⦹ᩍพ⧁äᮥᱽ⦹ᩡ
݅݅อݡᇡᇥ᮹ᩑǍᨱᕽᯥ⥭✙พ᭥⊹۵ᯕŖ
ᱥႊᇡᨱᕽ᳭ᬑݡ⋎ᯕࡹᨕ⦽݅۵äᮥŖ☖ᱢᮝಽ
ᱽ⦹Łᯩ݅
ၙܩᯥ⥭✙᮹ݡ⢽ᱢᯙᰆᱱᮝಽྕᱩ}ᙹᚁಽᯙ
⦽↽ᗭ⋉᮹⊹ഭaa܆⦹໑ ᯕᨱᷪ⦹ᵲᯕ
እƱᱢᛞía܆⦹݅۵äᯕ݅ၙܩᯥ⥭✙᮹ᷪ
⦹ᵲᨱݡ⦽ʑᵡᨱݡ⧕.VOEU॒ᮡพ☁Ⓧa
/DNᯝäᮥ %JMFL॒ᮡQFSJPUFTU᮹ᙹ⊹a_ ᔍ ᯕᯝĞᬑಽᱽ⦹Łᯩᮝ໑ ᝅᱽฯᮡᯥᔢᩑǍᨱᕽ
ᷪ⦹ᵲᯕᯕᨕḡŁᯩ݅⦹ḡอ.BSZPE॒ᮡ⦹ᵲ
A B C
D E F
G H I
Fig. 7. Indirect technique of attachment incorporation. (A) Eight weeks after implant insertion. (B) Application of spacer. (C) Relief of denture. (D) Connection of matrix. (E, F) Application of re-lining material. (G, H) Denture try-in and muscle manipulation. (I) Final prosthesis.
Jin-Hong Park et al. : Mandibular Mini-Implants Supported Overdentures: A Case Report. Implantology 2015
✙౩ᜅ᮹ᇥᔑᨱݡ⦽᧞ᱱŝݡᇡᇥ᮹ၙܩᯥ⥭✙a
5J"M7BMMPZಽᱽ᯲ࡽ݅۵ᱱ॒ᮥqᦩ⧁ভพ
⬥ⅩʑPTTFPJOUFHSBUJPO⩶ᖒᨱᵝ᮹ෝʑᬙᯝ⦥a
ᯩᨕᅕᯙ݅
ᯥ⥭✙⦝}᮹⊹ᨱᕽᨕ┽⊹ຝ✙᮹ᖁ┾ᮡᯥ⥭
✙᮹᳦ඹ ᦦešĥ ⨩ᬊŖe॒ᮥ᳦⧊ᱢᮝಽ⠪a⦹
ᩍđᱶ⦹íࡹ۵ߑ ,JN॒᮹TZTUFNBUJDSFWJFXᨱ
໕ ᨕ┽⊹ຝ✙᳦ඹᨱෙᯥ⥭✙᮹ᔾ᳕ᮉၰ⪹
ᯱ᮹อ᳒ࠥᨱ۵ᮁ᮹⦽₉ᯕ۵ᨧᨩᮝ໑ ษə֘ᯕ݅
ෙᨕ┽⊹ຝ✙ᨱእ⧕ᅕ℁ᱢ⧊ᄲ᷾ᯕኩჩ⦽äᮝಽ
ӹ┡ԍ݅݉ ၙܩᯥ⥭✙ᨱᔍᬊa܆⦽ʑᖒᨕ┽⊹
ຝ✙۵ᱽ⣩eᔢ⪙⪙⪹ᯕࡹḡᦫᮝအಽᚁᱥᱶ⪶⦽
ḥ݉⦹ᨱᅕ݅᪥ᄞ⦽⊹ഭĥ⫮ᯕ⦥⦹݅
᮹⊹ᨱᨕ┽⊹ຝ✙᮹NBUSJYෝᩑđ⦹۵ႊჶᮝಽ۵
ᯙᔢᮥ₥ा⦹ᩍǍᨱᕽḥ⧪⦹۵eᱲჶŝǍԕᨱᕽ
ᯕᰆᬊ ౩ḥᮥ ᯕᬊ⧕ᕽ ᩑđ⦹۵ Ḣᱲჶᯕ ᯩ݅
/JTTBO॒ᮡḢᱲჶŝeᱲჶᵲᅕ℁ᱢᯙ⧊ᄲ᷾ၰ
ᮁḡ᮹⊂໕ᨱᕽḢᱲჶᮥ⧪⦹ࠥಾǭᮁ⦹Łᯩ݅
⦹ḡอᯝၹᱢᮝಽ}aพࡹ۵ၙܩᯥ⥭✙⦝}
᮹⊹ᨱᕽǍԕḢᱲჶᮝಽᩑđ⦹۵äᮡᚁᯱ᮹܆ᙺࠥ
ෝ⦹အಽᯕᨱݡ⦽Łಅa⦥⧕ᅕᯙ݅ੱ⦽ᯥ⥭
✙᮹พbࠥᨱᅕ℁ྜྷ᮹⧊ᄲ᷾ၽᔾᯕᮁ᮹⦹
í᷾a⦹အಽᯥ⥭✙พݡ⋎ᖒၰ⠪⧪ᖒ⪶ᅕ ᨱᅕ݅ʫᮡᵝ᮹aǍࡽ݅
*7 결론
ၙܩᯥ⥭✙ෝᯕᬊ⦽⦹ᦦ᮹᪅ქߕ⊹ഭಽ⊹᳑
ᩑǍa⦥⦹݅
References
1. Feine JS, Carlsson GE, Awad MA, et al. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Montreal, Quebec, May 24-25, 2002. Int J Oral Maxillofac Implants. 2002; 17: 601-602.
2. Bidra AS, Almas K. Mini implants for definitive prosthodontic treatment: a systematic review. J Prosthet Dent. 2013; 109: 156-164.
3. Jofré J, Conrady Y, Carrasco C. Survival of splinted mini-implants after contamination with stainless steel. Int J Oral Maxillofac Implants. 2010;
25: 351-356.
4. Morneburg TR, Pröschel PA. Success rates of microimplants in edentulous patients with residual ridge resorption. Int J Oral Maxillofac Implants. 2008; 23: 270-276.
5. Elsyad MA, Gebreel AA, Fouad MM, et al. The clinical and radiographic outcome of immediately loaded mini implants supporting a mandibular overdenture. A 3-year prospective study. J Oral Rehabil.
2011; 38: 827-834.
6. Maryod WH, Ali SM, Shawky AF. Immediate versus early loading of mini-implants supporting mandibular overdentures: a preliminary 3-year clinical outcome report. Int J Prosthodont. 2014; 27: 553-560.
7. Kern JS, Kern T, Wolfart S, et al. A systematic review and meta-analysis of removable and fixed implant-supported prostheses in edentulous jaws: post-loading implant loss. Clin Oral Implants Res. 2015. doi:
10.1111/clr.12531. [Epub ahead of print]
8. Sendax VI. Mini-implants as adjuncts for transitional prostheses. Dent Implantol Update. 1996; 7: 12-15.
9. Lee SY, Choi DG, Paek JH, et al. Patients satisfaction for implant supported overdenture with small diameter implant. J Korean Acad Prosthodont. 2011; 49: 29-37.
10. Mundt T, Schwahn C, Stark T, et al. Clinical response of edentulous people treated with mini dental implants in nine dental practices.
Case Report
Gerodontology. 2015; 32: 179-187.
11. Dilek O, Tezulas E, Dincel M. Required minimum primary stability and torque values for immediate loading of mini dental implants: an experimental study in nonviable bovine femoral bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: e20-e27.
12. Allum SR, Tomlinson RA, Joshi R. The impact of loads on standard diameter, small diameter and mini implants: a comparative laboratory study. Clin Oral Implants Res. 2008; 19: 553-559.
13. Hasan I, Heinemann F, Aitlahrach M, et al. Biomechanical finite
element analysis of small diameter and short dental implant. Biomed Tech (Berl). 2010; 55: 341-350.
14. Kim HY, Lee JY, Shin SW, et al. Attachment systems for mandibular implant overdentures: a systematic review. J Adv Prosthodont. 2012; 4:
197-203.
15. Nissan J, Oz-Ari B, Gross O, et al. Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture. Clin Oral Implants Res. 2011; 22: 627- 630.
