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민환 야
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1 대한치주과학회지 : Vol. 37, No. 2(Suppl.), 2007 New maxillary anterior ridge classification according to ideal implant restorative position determined by CAT Young-Sang Park 1, Sang-Choon Cho 2, Kyoung-Nam Kim 1, Kwang-Mahn Kim 1, Seong-Ho Choi 3, Hong-Seok Moon 4, Yong-Keun Lee 1* 1. Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry 2. Department of Periodontology and Implant Dentistry, New York University College of Dentistry 3. Department of Periodontology, Yonsei University College of Dentistry 4. Department of Prosthodontics, Yonsei University College of Dentistry I. INTRODUCTION * This study was supported by the Medical Science and Engineering Research Program of the Korea Science & Engineering Foundation (KOSEF) grant funded by the Korea government (MOST) (No. R ). * Correspondence: Yong-Keun Lee, Department of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, 250 Seongsanno, Seodaemun-gu, Seoul ( leeyk@yuhs.ac) 385

2 Table 1. Clinical conditions presenting tissue deficiencies in the anterior maxilla Etiology Conditions Remarks Anatomic Pathologic Narrow alveolar crest and/or facial undercut of alveolar process Dental trauma Post traumatic conditions Acute or chronic infections Disuse bone atrophy Congenitally missing teeth Tooth avulsion with fracture of the facial bone plate Root ankylosis with infraocclusion, root resorption, root fractures Periodontal disease, periapical lesions, endo/perio lesions Long-standing tooth loss 386

3 II. MATERIALS AND METHODS 2. Characteristics of the measurements 1. CAT-scans selection III. RESULTS 387

Table 2. Proposed new classification system of ridge deformities Class I-A I-B II-A II-B III-A III-B IV Explanation The implant is completely surrounded by bone. No dehiscence or fenestration present.

Dehiscences are detected but no fenestrations are present. Only buccal or palatal dehiscence is present. Dehiscences are detected but no fenestrations are present.

4 Table 2. Proposed new classification system of ridge deformities Class I-A I-B II-A II-B III-A III-B IV Explanation The implant is completely surrounded by bone. No dehiscence or fenestration present. 2 mm of facial plate of thickness. The implant is completely surrounded by bone. No dehiscence or fenestration present. < 2 mm of facial plate of thickness. Dehiscences are detected but no fenestrations are present. Only buccal or palatal dehiscence is present. Dehiscences are detected but no fenestrations are present. Both buccal and palatal dehiscences are present. Fenestrations are detected but no dehiscence is present. Only buccal or palatal fenestration is present. Fenestrations are detected but no dehiscence is present. both buccal and palatal fenestrations are present. Both dehiscences and fenestrations are present. 388

5 IV. DISCUSSION Table 3. Distribution of ridge deformities of 144 CAT images Class Number Rate (%) I-A I-B II-A II-B III IV

6 390

7 391

8 392

9 VI. REFERENCES V. SUMMARY 393

10 394

11 - 국문초록 - 전산화단층영상을이용한이상적임플란트수복위치에따른상악전치부치조제의새로운분류 박영상 1, 조상춘 2, 김경남 1, 김광만 1, 최성호 3, 문홍석 4, 이용근 1* 1. 연세대학교치과대학치과생체재료공학교실및연구소 2. 뉴욕대학교치과대학치주및임플란트과 3. 연세대학교치과대학치주과학교실 4. 연세대학교치과대학보철과학교실 손상된부분무치악제는임플란트식립에많은어려움을야기한다이런치조제의손상은외상성발치안면외상치근단수술만성치주염으로인한발거임플란트실패등에기인하며특히상악전치부의경우는큰좌절을유발할수있다치조제손상의분류및임상처리방법에대한많은보고가있었으나수술에앞서방사선영상을통해경조직을평가하여심미적이고연조직과조화로운임플란트시술을위한임플란트의이상적인수복위치에따른분류법은소개된적이없었다본논문의목적은컴퓨터단층촬영분석을이용하여이상적임플란트수복위치에따른상악전치부치조제의손상을분류하고자하는것이다 본논문에서는뉴욕대학교치주 임플란트과의데이터를이용했으며다음경우에한하여자료를수집한후과의가상임프란트를이용하여개의증례를통한개의임플란트수복부위를평가하였다 상실된상악전치부증례만포함최소개의인접치아가상실된증례원래의치아각도를알수있는최소개의잔존치아존재치아외형형판을컴퓨터단층촬영시착용 분석결과이상의순측골을가지며열개나창이없는경우를제군이하의순측골을가지며열개나창이없는경우를제군한쪽편의열개를가지고있고창은없는경우를제군협설측모두열개를보이며창은없는경우를제군열개는없고한쪽편의창을보이는경우를제군열개는없고협설측모두창을보이는경우를제군열개및창을모두보이는경우를제군으로분류하였다 395

12 개의임플란트수복부위를분류해보면제군이로가장많았으며제군가제군가제군가제군가제군이순이었다제군이가장많은것은초진시치조제변형을감지하여컴퓨터촬영을의뢰했기때문으로여겨진다 본연구에서사용한임플란트보다큰일반적크기의임플란트적용시더많은숫자의치조제손상을보일것으로예상되므로임상가들은이런손상된치조제증례에서도좋은예후를보일수있도록정확한진단과골증대술과같은수술적접근법에도익숙해질수있도록노력해야할것이다 Key worlds: Implant, Ridge, Classification 396

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