The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report

악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례

  • Sang-Myeong Tak (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Chang-Mo Jeong (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Jung-Bo Huh (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • So-Hyoun Lee (Department of Prosthodontics, School of Dentistry, Pusan National University) ;
  • Mi-Jung Yun (Department of Prosthodontics, School of Dentistry, Pusan National University)
  • 탁상명 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 정창모 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 허중보 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 이소현 (부산대학교 치의학전문대학원 치과보철학교실) ;
  • 윤미정 (부산대학교 치의학전문대학원 치과보철학교실)
  • Received : 2022.09.22
  • Accepted : 2022.11.02
  • Published : 2023.01.31
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Abstract

Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

전체 치열에 걸쳐 나타나는 병적 마모는 교합 평면의 붕괴, 수직고경의 감소, 전치부 조기 접촉, 부적절한 전방유도 및 치아 이동의 문제를 야기하여, 측두하악관절 장애 및 저작 효율의 감소, 치아 과민반응 등의 증상을 유발한다. 과도한 치아 마모(wear)를 보이는 환자의 치료를 위해서는 원인에 대한 분석과 함께 수직고경 변화에 대한 평가가 선행되어야 한다. 본 증례의 환자는 45세 여성으로 악교정수술 병력이 있었으며, 임상 검사, 방사선 검사, 모형 분석을 통해 전반적인 치아의 마모, 상악 전치부의 치간 이개, 하악 과두의 후방위, 보철 수복을 위한 악간 공간 부족을 확인하였다. 수직고경 거상을 동반한 전악구강회복술을 계획하였으며, 가철성 교합 안정장치 및 임시보철물로 새로운 수직고경에 대한 환자의 적응을 평가하였고, 적응된 수직고경을 유지하기 위해 임시 수복물을 기준으로 교차 마운팅을 시행해 최종 지르코니아 보철물을 제작하였다. 교합 관계의 안정적인 회복을 통해 기능 및 심미적으로 만족할 만한 결과를 보였다.

Keywords

Acknowledgement

This paper was supported by the grant of clinical research funding of the Dental Hospital of Pusan National University in 2021.

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