ছߨ
ᔢᦦ ᱥ⊹ᇡ۵ ᔢᮝಽ ❭ᱩࡹʑ ᛍᬑ໑ ❭ᱩࡽ ᧲ŝ ᭥⊹ᨱ ᙹᅖᯕ ᇩa܆⦽ ⊹ᦥ۵ ᯥ⥭✙᮹ ᱢ᮲᷾ᯕ ࡹ ໑ ၽ⊹ ⬥ ᷪ พᮡ ᱩ}ෝ ↽ᗭ⪵⦹ᩍ ⊹ഭᇡ᭥᮹ ᩑ᳑Ḣᮥ ᅕ᳕⦹໑ eᱢ ᩍᮁa ᨧ۵ ⪹ᯱ᮹ Ğᬑ ⅾ ḥഭ ʑe ᮹ ݉⇶ᯕ a܆⦹݅. ੱ⦽ ᳑Ḣ⦺ᱢᮝಽࠥ ᷪ พŝ ḡᩑ พe᮹ ᮁ᮹⧁ อ⦽ ₉ᯕ۵ ᨧ݅Ł ᅕŁ ࡹŁ ᯩ݅.
1-3Lindhe ॒ᮡ ၽ⊹ ⬥ ⊹᳑ʼn᮹ ⯂ᙹ۵ ᯥ⥭✙ พ ᩍᇡ᪡ šĥᨧᯕ ᯝᨕӹ໑ ᷪ พᮥ ⦽ Ğᬑᨱࠥ ⊹᳑ʼn᮹
⩲ᖅ⊂᮹ ʼn ⯂ᙹa šₑࡽ݅Ł ᅕŁ⦹ᩡ݅.
4,5ᕽ ᝍၙᖒᯕ Ǎࡹ۵ ᔢᦦ ᱥ⊹ᇡ ၽ⊹ ⬥ ᷪ พ ⩲⊂ʼnᮥ ⋉ჵ⦹ḡ ᦫí ⩲⊂ʼnŝ 2mm ᯕᔢ Ŗeᮥ ⪶ ᅕ ⬥ Ǎ}⊂ᮝಽ ⊹ᬑ⊽ ᭥⊹ᨱ พ⦹ᩍ ⩲⊂ʼn᮹ ⯂ᙹa ᯩᨕࠥ እᝍၙᱢᯙ đŝa ᯝᨕӹḡ ᦫࠥಾ ⧕ ⦽݅.
6ʑ᳕᮹ Metal Abutment۵ ⩲⊂ ⊹᳑ʼn ⯂ᙹ ᝍၙᱢᮝಽ ๅᬑ ᇩญ⦹ᩍ ↽ɝ ⊹ᦥ᪡ ᔪᔢᯕ ᮁᔍ⦹Ł vࠥa ᬑᙹ
⦽ Zirconia Abutmentᨱ ݡ⦽ ฯᮡ ᩑǍa ḥ⧪ࡹᨩᮝ໑ Nakamura ॒ᮡ Zirconia abutmenta ᱥ⊹ᇡᨱᕽ ᔍᬊ⦹ʑᨱ
∊ᇥ⦽ vࠥෝ aḡŁ ᯩᮝ໑ ⊹┽᮹ ⋉₊ࠥ ┡ᯕ┡ۥᅕ݅ ᱢí ᯝᨕӹ Peri-implantitisࠥ ᱢᮥ äᯕŁ ᅕŁ⦹ᩡ݅.
7↽ɝ CAD/CAM(Computer aided design/Computer aided manufacture) Zirconia ᅕ℁ྜྷᮡ vࠥᨱ ᯩᨕᕽ ʑ᳕᮹ ᱥ ᇡࠥᰍš ᰍഭᅕ݅ v⦽ vࠥෝ aḡŁ ᯩᮝ໑
8ᄡᩑᱢ⧊ࠥᨱᕽࠥ ʑ᳕᮹ ᰍഭ᪡ ᮁ᮹⧁ อ⦽ ₉ᯕa ᨧ݅Ł ᅕŁࡹ
Ł ᯩ݅.
9ᯕჩ ᷾ಡᅕŁ۵ ᱥᝁᄲಆᯕ ᨧ۵ ⪹ᯱ᮹ ᝍၙᖒᯕ Ǎࡹ۵ ᔢᦦ ᱥ⊹ᇡᨱ ᔢᮝಽ ᯙ⦽ ᳭ᬑ ᔢᦦᵲᱩ⊹ ⊹ɝ
❭ᱩಽ ၽ⊹ ⬥ ᷪ ᯥ⥭✙ෝ พ⦹Ł CAD/CAM Zirconia abutmentෝ ℕđ ⬥ Provisional restorationᮥ ⧪ ⬥
⊹e ᮁࢱ᮹ ⫭ᅖᮥ ᮁࠥ⦽ अ CAD/CAM Zirconia restorationᮥ ⧪⦽ ᷾ಡᯕ݅.
ହঃஹߢ
ʡᬕᖒ ᗱᕽḥ ᧲ၙᩢ ᰆᕾᬑ ᮁ⩥ၙ ၶ࠺ᖒ ᪅┽ᕾ
ᕽᬙᔝᖒ⊹ŝ ᖒɁšݡ⦺Ʊ᮹ŝݡ⦺ᔝᖒᕽᬙᄲᬱ⊹ŝᅕ᳕ŝ
Journal of the Korean Academy of Esthetic Dentistry
ᨩ݅.(Fig. 1,2,3) Low smile lineᯕ šₑࡹ໑(Fig. 4) #11,21۵ ၽ⊹
⬥ ᷪ ᯥ⥭✙ෝ พ⦹ʑಽ ĥ⫮⦹ᩡ݅.
ǎᗭ ษ≉⦹ᨱ(ᩝᔑญࠥ⋕ᯙ, Ų, ݡ⦽ၝǎ) Periotomeᮥ ᯕᬊ
⦹ᩍ ᔢᨧᯕ ⊹ᦥෝ ၽ⊹⦽ अ ❱ส Ñᔢ ᨧᯕ ⊹ɝ℉ᨱᕽ 3mm ᔢႊ Ǎ}⊂ ⊹᳑ʼnᨱ ऽตย⦹Ł ḢĞ 3.5mm ʙᯕ 10.0mm ᯥ⥭
✙(GS 3, Osstem, Korea)ෝ 30Ncm᮹ ☁Ⓧಽ พ⦹ᩡ݅. ᷪ พ
ᯥ⥭✙᮹ ⩲ᖅ⊂ ᭥⊹۵ ᯙᱲ⊹᮹ ᖅ໕ đᱩ ᇡ᭥᪡ ᯝ⊹⦹í ⦹ᩡŁ ɝᬱᝍᮝಽ ᯙᱲ⊹᪡ 2mm Ñญෝ ⪶ᅕ⦹
ᩡ݅.
10#11ᨱ۵ 5.5mmḢĞᨱ 7mm #21ᨱ۵ 5.5mmḢĞᨱ 5mm healing abutment(Osstem, Korea)ෝ ᩑđ ⬥ ᯥ⥭✙
᪡ ⩲⊂ ʼnᔍᯕ Ŗeᨱ ┩݉႒ᬑʼn(Bio-Oss, Geistlich AG, Wolhusen, Swizerland)ᮥ ₥ᬭ քᮡ ⬥ Collatape(Zimmer Dental, Caslsbad, CA)ෝ ᔢᇡᨱ ߏᨕᵡ अ 5-0 nylon(Blue Nylon, Ailee, Pusan, korea) ಽ ᅪ⧊⦹ᩡ݅.(Fig. 5,6,7)
5}ᬵ अ ԕᬱ⦹ᩍ ႊᔍᖁᔢ ᗭčŝ(Fig. 8) ᝍၙᱢᮝಽ อ᳒⧁ อ⦽ ⊹ᮁ᧲ᔢᮥ ᅕᩍ(Fig. 9) #11ᮡ ḢĞ 5.5mm ׳ ᯕ 5mm healing abutment(Osstem, Korea)ಽ Ʊℕ⦹ᩡ݅.
⊹ᮡ┱⋉ᮝಽ Probing⬥ ᯕෝ ₙŁ⦹ᩍ ⊹ᮡᮥ ⩶ᖒ⦹ᩡŁ ⇵⬥ ⊹ᮡ♕⇽ ⬥ᨱࠥ ᝍၙᱢᯙ ྙᱽෝ ↽ᗭ⪵⦹ʑ ᭥
⧕ Zirconia Abutment(Osstem Korea)ෝ ༉⩶ᔢᨱᕽ ᔎᱽ⦹Ł Provisional restorationŝCAD/CAM Zirconia Coping (Cercon, Degudent, Germany)ᮥ ᱽ᯲ ⦹ᩡ݅.
՜տսՄԶՇՂԶՈՄ⊹ᦥ❭ᱩࡽᯥᔢᔍḥ
՜տսՄԶՉՄ-PXTNJMFMJOF
՜տսՄԶՊՄⅩḥႊᔍᖁᔍḥ
ᚁ ⬥ 8}ᬵ ⬥ ʑᖒ Zirconia Abutment(Osstem Korea) ۵ ༉⩶ᔢᨱᕽ ᱽ᯲ ⬥ Zigෝ ᯕᬊ⧕ᕽ Ǎvԕᨱᕽ Abutmentෝ ᩑđ ⬥ Provisional restorationᮥ ⧪⦹ᩡ
݅. ⊹eᮁࢱa ᗭᝅࡹᨕ ⊹᳑ʼn܆ᮝಽᇡ░ 5mm ᔢႊᨱ ᱲⅪᱱᯕ ᪅ࠥಾ ᳑ᱩ⦹ᩡ݅. ႊᔍᖁᔍḥᔢᨱࠥ ʼn⯂ᙹ
᧲ᔢᯕ ၽčࡹḡ ᦫŁ ᯩ݅.(Fig. 10,11,12,13)
ᚁ ⬥ 10}ᬵ, Provisional restoration ⬥ 2}ᬵ अ ⊹ᮡ
ᮁࢱa ⫭ᅖᯕ ࡹᨩŁ ⩲⊂ ⊹᳑ʼn᮹ ⯂ᙹࠥ šₑࡹḡ ᦫᦥ ↽᳦ᅕ℁ྜྷᮥ ᱽ᯲⦹ᩡŁ ᯥ⥭✙ᬊ ౩ḥູ✙
(Premier implant cement, Premier, Hannover, Germany)ෝ
՜տսՄԶՎՄᚁ⬥}ᬵႊᔍᖁᔍḥ
՜տսՄԶՍՄᚁ⬥ႊᔍᖁᔍḥ
՜տսՄԶՋՂԶՌՄၽ⊹⬥ᯥ⥭✙ᷪพ⬥⩲⊂ᨱ#JPPTT₥ᬭᵡअᅪ⧊
Journal of the Korean Academy of Esthetic Dentistry
ᙹᚁ ⬥ 10}ᬵअ ႊᔍᖁᔍḥᔢ ✚ᯕᔍ⧎ᮡ šₑࡹḡ ᦫᦹ
݅.(Fig. 18)
ഠଭ
Schropp ॒ᮡ ᔢᦦ ᱥ⊹ᇡ᮹ ၽ⊹ ⬥ ᷪ พŝ ḡᩑ พ e᮹ ⊹ᦥ ᵝ᭥᮹ ᩑ᳑Ḣŝ Ğ᳑Ḣ᮹ ᄡ⪵ෝ Ⅹʑ 3}ᬵ࠺ᦩ šₑ⦹ᩍ ᷪ พŝ ḡᩑ พ ༉ࢱ Bone defect᮹ qᗭa š ₑࡹŁ ᷪ พ⦽ Ğᬑᨱࠥ Infrabony defectᨱᕽࠥ ᔩಽᬕ ʼn⩶ᖒᯕ ᯝᨕӽ݅Ł ᅕŁ⦹ᩡ݅.
11ə్ӹ Lindle ॒ᮡ Beagle dog ᝅ⨹ᨱᕽ ၽ⊹ ⬥ ᯥ⥭✙
ᷪ พ⦽ Ğᬑᨱࠥ 1}ᬵ अ ᳑Ḣ⦺ᱢᮝಽ ⊹᳑ʼn᮹ ⩲ᖅᨱ ᕽ ⓑ ⯂ᙹෝ ᅕŁ⦹ᩡ݅.
5⦹ḡอ ၽ⊹ ⬥ ᯥ⥭✙۵ ᙹᚁ᮹ ⬀ᙹ᪡ ᅕ℁ᙹᅖʭḡ e
ᮥ ݉⇶┍ ᙹ ᯩᮝ໑ ᯥ⥭✙ ᵝ᭥ ᩑ᳑Ḣ᮹ ᄡ⪵ෝ ↽ᗭ⪵⧁
ᙹ ᯩ݅۵ ᰆᱱᯕ ᯩ݅. ੱ⦽ ၽ⊹ ⬥ ᯥ⥭✙᮹ ᷪ พ⦽ Ğ ᬑᨱ ᝍၙᱢᮝಽࠥ อ᳒⧁ อ⦽ đŝॅᯕ ᅕŁࡹŁ ᯩ݅.
12Tarnow॒ᮡ ᯱᩑ⊹ᨱᕽ ᱲⅪᱱŝ ⊹᳑ʼnᱶ᮹ Ñญa 5mm ᯕ⦹ᨱᕽ 100%, 6mm ᨱᕽ۵ 56% əญŁ 7mm ᯕᔢᨱᕽ۵ 27%ᯕ⦹ಽ ⊹e ᮁࢱa ₥ᬭḥ݅Ł ᅕŁ⦹ᩡᮝ໑ ᯕ۵ ᯱᩑ
՜տսՄԶ ՇՆՂՇՇՂՇՈՄ;JHෝᯕᬊǍvԕ[JSDPOJBBCVUNFOUᩑđ⬥
1SPWJTJPOBMSFTUPSBUJPO⊹ᮡᮁࢱᨱŖeᯕᯩᮭ
՜տսՄԶՇՉՄᚁ⬥}ᬵअႊᔍᖁᔍḥ
⊹ ᐱอ ᦥܩ ᯥ⥭✙ᨱᕽࠥ ᱢᬊࡹᨕ ᯥ⥭✙ e᮹
⊹e ᮁࢱ᮹ ᮁḡ᪡ ⫭ᅖᨱ ₙŁ ᔍ⧎ᯕ ࡹŁ ᯩ݅.
13↽ɝ CAD/CAM Zirconia۵ ׳ᮡ vࠥ᪡ ᝍၙᖒᮥ aḡ ໑ ᄡᩑ ᱢ⧊ࠥࠥ ᯥᔢᱢᮝಽ ᙹᬊ⧁ ᙹ ᯩ۵ ᙹᵡᯕᕽ ᔢᦦ ᱥ⊹ᇡ᮹ ᝍၙᙹᅖᨱ ᯩᨕ ᅕ݅ ᝍၙᱢᯕ໑ ŝÑ᮹ ᱥᇡࠥᰍšᅕ݅ ᦩᱶᱢᯕ݅.
9,14էߨ
ᔢᮝಽ ᔢᦦ ᵲᱩ⊹ ༉ࢱ ⊹ɝ ❭ᱩࡽ अ ၽ⊹ ⬥ ᷪ
พ ⬥ Zirconia Abutment᪡ Provisional restorationᮝ ಽ ᵲᱩ⊹e ⊹eᮁࢱෝ ⫭ᅖ ┉ ⬥ Zirconia restoration ᮝಽ ᙹᅖ⦹ᩍ ᚁ ⬥ 10}ᬵʭḡ ᝍb⦽ ʼn ⯂ᙹӹ ᩑ᳑Ḣ ᮹ ♕⇶ᮡ ᅕᯕḡ ᦫᮝ໑ ᝍၙᱢᯙ đŝෝ ᮁḡ⦹ᩡᮝӹ ᦿᮝಽ ᵝʑᱢᯙ šₑŝ ᮁḡa ⦥⦹݅.
՜տսՄԶՇՎՄᚁ⬥}ᬵႊᔍᖁᔍḥ
՜տսՄԶՇՊՂՇՋՂՇՌՂՇՍՄ1SPWJTJPOBMSFTUPSBUJPO}ᬵअ⊹ᮡᮁࢱ᮹⫭ᅖŝ↽᳦ᅕ℁ྜྷᱲ₊⬥ᯥᔢᔍḥ ⩲⊂⊹᳑ʼn᮹⯂ᙹašₑࡹ
ḡᦫᦹ݅
Journal of the Korean Academy of Esthetic Dentistry 2006;201:199-205
Nakamura K, Kanno T, Milleding P, Ortengren U. Zirconia as a dental implant abutment material: a systematic review. Int J 8.
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Jung YG, Peterson IM, Kim DK, et al: Lifetime-limiting strength degradation from contact fatigue in dental ceramics. J Dent 9.
Res 2000;79:722-731.
Reich S, Wichmann M, Nkenke E, Proeschel P. Clinical fit of all-ceramic three-unit fixed partial dentures, generated with three 10.
different CAD/CAM systems. Eur J Oral Sci 2005; 113: 174–179.
Buser D, Belser U, Wismeijer D. Implant therapy in the esthetic zone single tooth replacement, p25-p37, Chicago, IL Quintes- 11.
sence Publishing.
Schropp L, Kostopoulos L, Wenzel A. Bone healing following immediate versus delayed placement of titanium implants into 12.
extraction sockets: A prospective clinical study. Int J Oral Maxillofac Implants 2003;18:189–199
Schwartz-Arad D, Chaushu G. Placement of implant into fresh site:4 to 7 years retrospective evaluation of 95 immediate im- 13.
plants, J Periodontol 1997;68:1110-1116
Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or ab- 14.
sence of the interproximal dental papilla. J perio
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