• 윤원장의치아이야기
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윤원장의치아이야기

프레타우 지르코니아 - 차세대 CAD/CAM을 이용한 지르코니아 크라운

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작성자 최고관리자 작성일16-02-19 17:11 조회4,863회 댓글2건

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안녕하세요. 윤서준 원장입니다.

 

오늘은 저희 병원에서 사용하는 지르코니아 크라운 - 프레타우에 대해 설명드리겠습니다.

기존에 알고 계시던 크라운과 달리 새로운 개념의 크라운이라 자세한 설명을 하게 되었습니다.

 

크라운(전부금관)이란 치아가 파절이나 충치에 의해 손상된 정도가 심하여 부분적인 회복이 불가능할 때 전체를 수복하는데 사용되는 치과 보철물을 뜻합니다.

전통적으로 오랜 기간 동안 사용된 재료는 금(gold)로 적합성, 강도, 경도 등의 물리적 성질이 우수하여 널리 사용되어 왔습니다.

 

 

유일한 단점은 치아와 다르게 금속색을 띠기 때문에 심미적인 단점이 있으며,

이를 보완하기 위한 재료로 금속-도재 금관(PFM: Porcelain fused metal crown)이 사용되었습니다. PFM재료는 골드에 비해 심미적으로 우수하지만 도자기의 특성상 파절 될 수 있는 단점이 있습니다.

  

쉽게 말해 도자기를 구워서 만드는 방식인 도재 크라운은 파절 저항성이 취약하기 때문에 발전을 거듭하여 파절에 저항성을 가지는 CAD/CAM 방식의 강화 도재 크라운이 개발되었으며

현재 다양한 회사의 강화 도재 크라운이 사용되고 있습니다.

50674cb968b7b96ab9b37b7333d6ec47_1455869

 

그 중 지르코니아 크라운은 우수한 심미적인 장점을 가지고 있으며,

강화 처리된 지르코니아를 압축 소성과정을 거친 후 만들어내어 구강 내에서 골드에 유사한 쉽게 파절되지 않는 강도를 가지게 되었습니다.

이러한 지르코니아 크라운도 다양한 회사에서 제품을 선보이고 있는데요.

 

그 중 Zirkonzahn에서 만든 Prettau 제품이 널리 사용되고 있습니다.

 

 50674cb968b7b96ab9b37b7333d6ec47_1455869

프레타우 크라운의 제작 과정

 

1.     치과에서 임상과정을 거쳐 인상을 채득하여(일반적으로 본을 뜬다고 함) 기공소에 보내면 석고 모델이 만들어집니다.

본을 뜨지 않고 편리하게 임상 구강카메라를 이용하여 디지털 인상 채득을 할 수 있다.

하지만 아직 디지털 인상채득에 오차가 모델을 통한 오차에 비해 크다고 필자는 이해하고 있어서 기존의 석고 모델을 제작하는 방식을 선호하게 되었습니다.

 

2.     제작된 석고모델을 디지털 스캔 장비에 넣고 3차원 정보를 얻게 됩니다. 다음과 같은 기계에 석고 모델(지대치, 대합치)여러 방향으로 스캔하게 되는데 기공사의 스킬과 프로그램 숙지 정도에 따라 정확도가 높아지고 작업시간이 단축되게 됩니다.

50674cb968b7b96ab9b37b7333d6ec47_1455873

3.     디지털 채득된 정보를 이용하여 제작될 크라운의 형태와 교합관계를 프로그램 작업이 이루어집니다. 역시 프로그램을 얼마나 정확하게 설계하는지가 관건입니다.

50674cb968b7b96ab9b37b7333d6ec47_1455873

4.     설계된 정보를 컴퓨터로 전송하여 실제 CAD/CAM 기계를 이용하여 지르코니아 프레타우 블록을 밀링하기 시작합니다. 프레타우 정품블록을 쓰는지 호환되는 블록을 쓰는지 확인할 수 있습니다.

50674cb968b7b96ab9b37b7333d6ec47_1455871

 

5.     밀링이 완료되면 건조 과정을 거치게 되며 sintering 과정을 통하여 최종적으로 구강 내 장착 가능한 크기와 강도를 얻게 됩니다.

50674cb968b7b96ab9b37b7333d6ec47_1455871

 

6.     완성된 지르코니아 프레타우 크라운은 후작업을 통해 적합도, 교합 관계, 인접면 관계를 점검한 후 staining & glazing 과정을 통해 자연스러운 치아 색조를 얻게 됩니다.

50674cb968b7b96ab9b37b7333d6ec47_1455871

다양한 staining powder

 

7.     완성 후 구강내 장착.

50674cb968b7b96ab9b37b7333d6ec47_1455872

 

위의 과정을 통하여 CAD/CAM 방식의 지르코니아 크라운이 완성되게 됩니다.

위의 사진은 모두 저희가 거래하는 기공소에서 제가 직접 설명 듣고 촬영한 것입니다.

남우 기공소 (남영우 소장)  02-3275-2828​

실제 기공물이 어떻게 제작되는지 수시로 확인하고 점검하는 것도 양질의 보철물을 유지하는 방법이라 생각되네요..​

 

결론적으로 지르코니아 프레타우 크라운은 기존의 PFM크라운보다 단단하면서도 GOLD 크라운보다 우수한 심미성을 가지는 크라운이라 할 수 있겠습니다.

 

긴 글 읽어주셔서 감사합니다.

 

 

 

 

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