• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.337-347
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• 2009

The treatment of a patient with severely worn dentition is often challenging due to loss of vertical dimension and an uneven occlusal plane. To establish a correct occlusal plane and space for prostheses, it is necessary to increase vertical dimension. Occlusal vertical dimension is the vertical position of mandible to maxilla in centric occlusion. McAndrew reported that in spite of the change of the vertical dimension, the altered occlusion would be maintained if the equal occlusal contacts were established in centric relation. Centric relation is defined as an anatomically and physiologically stable, repeatable posture of the mandible and can be considered a most acceptable treatment and reference position. In this case we tried to treat patients with severely worn dentition by the use of centric relation and increased vertical dimension for the space of prostheses.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.329-338
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• 2014

Patients who lost molars from dental caries or periodontitis have difficulty in maintaining their vertical dimension because their incisors and premolars also show vertical tooth movement. Missing posterior molars leads to occlusal interference and collapse of occlusal plane due to extrusion of opposite teeth and tipping of adjacent teeth. When this condition persists over long time, mandible moves forward, so it causes mobility and labioversion of upper incisors. This progress cannot be stopped spontaneously and the situation gets worse and worse. Therefore, for a patient with pathologic teeth migration caused by chronic periodontitis, interdisciplinary approach which is including periodontal treatment, orthodontic teeth alignment and prosthetic restoration of missing molars is required. This case report shows successful multidisciplinary approach to a patient who lost vertical dimension due to severe dental caries and periodontitis.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.214-223
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• 2016

Implant-assisted removable partial denture (Implant-assisted RPD, IARPD), posterior edentulous extension areas of which obtains additional support and retention from implants, is attracting increasing interest. This case report presents a successful treatment on a partially edentulous patient with a severely canted occlusal plane resulted from a long-term use of posterior extended RPD. The full mouth was rehabilitated through a fixed prosthesis on maxilla and IARPD with zirconia occlusal surface on mandible, which allowed to achieve an esthetic occlusal plane with long-term stability and, ultimately, functionally satisfying outcome.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.225-231
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• 2021

There are many studies on the indications and efficacy of splint therapy commonly used in patients with temporomandibular disorders (TMD). However, there have been no studies on the splint weaning in terms of the splint use tapering period in relation to symptom improvement of TMD. This retrospective study aims to analyze a proper splint weaning method in patients with TMD based on symptom improvement. Materials and Methods: The authors examined 130 TMD patients with TMJ disorders, masticatory muscle disorders, and clenching/bruxism who had received splint therapy (occlusion stabilization splint, anterior positioning splint) of patients who visited the Department of Orofacial Pain and Oral Medicine at Yonsei University Dental Hospital from 2015 to 2020. They were evaluated according to the method to wean splints. Results: The mean splint therapy period was 29.0 months, during which patients wore splints 7 days a week for 8.4 months, 3 - 4 days a week for 9.5 months, and finally 1 - 2 days a week for 11.1 months (a total of 29.0 months, about 2.5 years). Conclusion: It seems that TMD symptoms can be alleviated and side effects such as occlusal change can be minimized if patients wear a splint 7 days a week for the first 6 months, followed by 3 - 4 days a week for the next 6 to 18 months, and finally 1 - 2 days a week after 18 months.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.284-292
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• 2023

Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.

• The korean journal of orthodontics
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• v.39 no.2
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• pp.72-82
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• 2009

Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.477-482
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• 2010

In a case of multiple posterior teeth loss, antagonistic teeth extrude to the edentulous space and compensatory occlusion on the remained anterior teeth leads to occlusal trauma. Extrusion of antagonistic teeth breaks down occlusion plane and loss of posterior support bring about severe wear of remained teeth. In this situation, it is needed to restore remained teeth and edentulous space by increasing vertical dimension to obtain prosthodontic rehabilitation space and to correct occlusion plane. In this case report, the patient had a masticatory problem with loss of posterior teeth support and an esthetic problem of shortened anterior teeth. Before the tooth preparation for the prosthodontic restoration, the patient used removable device for 2 months to increase vertical dimension reversibly. After that, he got provisional fixed restoration with irreversible tooth reduction and used it for 3 months. It had spent 5 month to evaluate the adaptation state on final restoration with incresed vertical dimension. The increasing amount was 3 mm, which was relatively in less degree and masticatory system adapted to the increased vertical dimension without any pathologic changes. Final restoration was made to have equal-intensity contacts on all teeth in a verifiable centric relations and immediate disclusion of all posterior contacts the moment the mandible moves in any direction from centric relation. In addition, metal occlusion surface on posterior teeth was applied to prevent excessive muscle activation, occlusal trauma and the porcelain fracture.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.133-145
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• 2023

Class III malocclusion with mandibular protrusion can be divided into skeletal and pseudo malocclusion due to tooth displacement. For skeletal malocclusion, favorable treatment results can be obtained by establishing an appropriate vertical and horizontal intermaxillary relationship in order to secure a restoration space and obtain aesthetic and functional results. In this case, complete mouth rehabilitation was performed using an implant and a fixed prosthesis in a patient with mandibular protrusion and anterior teeth wear and reduced occlusal vertical dimension. After cast analysis and digital diagnosis, a provisional restoration with increased vertical dimension was fabricated to secure posterior support and evaluate stable centric occlusion. With the definitive prosthesis reflecting the provisional restoration, favorable function and aesthetics were obtained.

• The korean journal of orthodontics
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• v.26 no.1 s.54
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• pp.65-82
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• 1996

This study was carried out to study the changing patterns in muscle activities in Angle's II and Class III malocclusion patients following activator therapy, To study the activities of anterior temporal(T.A.), masseter(M.M.), posterior temporal(T.P.), and anterior belly of digastric(D.A.) muscles, surface electrodes were placed on 15 Angle's Class II and 17 Angle's Class III malocclusion patients and following conclusions were obtained after electromyographic recordings were taken at prior to the activator therapy and at some time between 6 -12 month after the start of activator therapy. 1. Class II and Class III malocclusion groups, when compared to normal occlusiongroup, showed no significant differences during resting and swallowing. But significant differences were observed in masseter and posterior temporal muscles during clenching. 2. Most of the muscles studied showed a certain pattern, that is those groups whose pre-treatment E.M.G. were lower than the normal value showed significant increase after activator therapy, whereas those groups whose pre-treatment E.M.G. were higher than the normal value showed significant decrease after activator therapy. This pattern was observed in all of the muscle groups studied except T.A.(swallowing), T.P.(clenching) and D.A.(swallowing, clenching) in Angle's Class III malocclusion group and in Angle's Class II malocclusion group, above tendency were observed only in T.A.(swallowing), M.M.(resting, swallowing) and T.P.(clenching). This pattern was less obvious during clenching. 3. When E.M.G. activity after activator therapy between Angle's Class II and Class III malocclusion group was compared, Class III malocclusion group showed more increase during resting, and Class II malocclusion group showed more increase during swallowing and clenching excepting M.M. and D.A. respectively.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.45-55
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• 2005

As people prefer to use right or left hand, some have preferred chewing side while others do not. Totally, 82 volunteers composed of students and staffs from Dental Hospital College of Dentistry Yonsei University participated in this study for the investigation of influence of preferred chewing habit, that has lasted for more than a year, on electromyographic(EMG) activity of masticatory muscles and bite force. Among the 82 volunteers, 46 had preferred chewing habit while the other 36 did not. Prior to the investigation, those with factors that could affect the study, such as, general disease, irregular dentition and malocclusion, were screened and excluded by questionnaire and clinical examination. The results were as follows: 1. There was no significant difference in EMG activities between chewing side and non-chewing side of preferred chewing subjects at rest as well as maximal voluntary contraction(MCV)(p>0.05). 2. Asymmetrical coefficient of temporal and masseter muscle EMG activities between preferred chewing subjects and non-preferred chewing subjects at rest was not significantly different(p>0.05). 3. Asymmetrical coefficient of masseter EMG activity was significantly higher(p<0.05) than that of non-preferred chewing subjects at MCV, whereas that of anterior temporal muscle showed no difference(p<0.05). 4. In preferred chewing subjects, there was no significant difference in average bite force and occlusal contact area between chewing side and non-chewing side(p>0.05). 5. There was no significant difference in Asymmetrical coefficients of average bite force and occlusal contact area between preferred chewing subjects and non-preferred chewing subjects (p>0.05). Consequently, preferred chewing habit can be considered as physiological asymmetry with normal function rather than to have influence on EMG muscle activity of masticatory muscles, average bite force and occlusal contact area. Objective standardization to differentiate preferred chewing subjects and non-preferred chewing subjects should be established in the further study.