• Title/Summary/Keyword: 교합안정

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Evaluation of various cephalometric measurements to predict the prognosis of early Class III malocclusion treatment (III급 부정교합의 조기 치료 예후 예측를 위한 두부방사선 계측 변수의 평가)

  • Son, Myung-Ho;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.3 s.104
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    • pp.205-218
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    • 2004
  • The aims of this study were to investigate the differences in the early craniofacial morphology of Class III malocclusions with good, fair and poor occlusal stability and to elucidate a key determinant for distinguishing the cases. Lateral cephalograms of 30 subjects with Class III malocclusion in the mixed dentition were analyzed at the start of treatment (mean age of $8.58\pm1.47$). All subjects were reevaluated after a mean period of $7.50\pm1.94$ years comprising active treatment and retention. At this time, the samples were divided into three groups: good (10 subjects), fair (10 subjects) and poor (10 subjects) occlusal stability groups. According to the results of ANOVA, there were significant morphological differences in the early stage among the good, fair and poor occlusat stability groups, especially in variables that represented the vertical skeletal relationships. As well, there were already more dental compensations in the poor occlusal stability group. Stepwise discriminant analysis on the measurements at the time of first observation identified only one predictive variable: AB to mandibular plane angle(AB-MP). With this discriminant function, $83.3\%$of the original grouped cases were correctly classified and the canonical correlation coefficient was 0.857. In conclusion, AB-MP can be a possible predictor for the eventual prognosis of early Class III treatment. If it is below 60, the prognosis of early Class III treatment is expected to be poor, while if it is above 65, a good prognosis is expected.

The prosthetic approach and principle for an collapsed VDO ; A clinical case of pseudo Class III patient (저위교합환자의 보철적 접근법과 이론 : Pseudo Class III 교합환자 증례)

  • Kwon, Kung-Rock;Choi, Dae-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.20 no.2
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    • pp.121-134
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    • 2004
  • This article describes a clinical protocol for the conventional rehabilitation of patient diagnosed with partial anodontia. A combined dental therapy approach was used and included endodontic therapy and root capping on the maxillary central incisors, fabrication of a maxillary overdenture, and fabrication of mandibular konus overdenture supported by 3 konus abutments. Within this protocol, tooth-supported overdenture prostheses are used for 2 purposes: first, to obtain the most rigid retention and function at an established maxillary-mandibular relationship; and second, to continuously maintain function and esthetic appearance applying immediate dentures after teeth extraction. The idea behind this protocol and its associated clinical procedures is presented along with a discussion compared with implant therapy. In the case introduced, and after 7 years of observation, the therapy can be seen as a success. We increased the occlusal vertical height in this case, but it would be more appropriate to see this as recovering the occlusal vertical height that was lost. The process of increasing the occlusal vertical height, that is restoration of the face, modification of the extrinsic occlusion of the incisors, and retraction of the mandible is very difficult and important. Ultimately, class III malocclusion is fixed, adequate occlusal vertical height is gained, and the retracted posterior anodontial portion is restored by prosthodontic dentures based on the rigid support theory. The result of the therapy done on the later-achieved malocclusion with partial anodontia on the posterior portion must consider the following in order to maintain the safety of the esthetics of the tooth and face for a period of time: 1) occlusal restoration with an ideal occlusal vertical height, 2) allowance of the final occlusion induced by the functional relationship of the upper and lower jaw, 3)final occlusion functionally induced by the lip competence limit.

Prosthetic treatment with correcting edentulous maxillomandibular relation (무치악치조제의 개선을 통한 보철치료)

  • Rhee, Ye-Kyu;Huh, Yoon-Hyuck;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.339-349
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    • 2014
  • If the maxillomandibular relationship is unstable or requires treatment for improved function and esthetics, the first treatment objective is to provide stable occlusal contacts. The patient has moderate mental retardation. Due to inadequate vertical overjet, horizontal arch malrelation and excessive tooth loss, full mouth rehabilitation was required. The purpose of treatment planning is to establish physiologic maxillomandibular relation. Using cephalometrics for occlusal analysis is an aid to make a decision. The amount of horizontal bone reduction was calculated with evaluating soft tissue profile. After provisional denture placement, healing of the surgical site and newly adapted arch relationship was evaluated. The patient satisfied with esthetics and showed stable holding contacts. Periodic examination is needed to exclude occlusal disharmony.

Postoperative Stability and Occlusal Plane Alternation by Orthognathic Surgery of Skeletal Class III Malocclusion with Anterior Open Bite (전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구)

  • Shin, Soo-Jung;Hwang, Byung-Nam;Lee, Jung-Keun;Rhee, Seung-Hoon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.113-127
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    • 1999
  • The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

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Management of Temporomandibular disorder (측두하악장애의 치료)

  • Jung, Da-Woon;Chung, A-Young;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.441-452
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    • 2012
  • Most of signs and symptoms of temporomandibular disorder(TMD) is temporary and self-limiting as other musculoskeletal diseases. Conservative, reversible treatment; self care, behavior modification, physical therapy, pharmacotherapy, splint therapy should be considered as initial treatment for temporomandibular disorder rather than non conservative, irreversible treatment.

Full mouth rehabilitation of the patient with worn dentition using full-contour monolithic zirconia prostheses at an increased vertical dimension of occlusion: a case report (치아 마모 환자에서 수직고경 증가를 동반하여 단일구조 지르코니아 보철물로 완전구강회복을 시행한 증례)

  • Oh, Kyung-Chul;Chung, Moon-Kyu;Kim, Jee-Hwan;Shim, June-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.198-203
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    • 2012
  • Excessive occlusal wear results in unacceptable damage to the occluding surfaces, and can cause pulpal injury, occlusal disharmony, impaired function, and aesthetic deformity. Patients with severely worn dentition need to be classified as several categories relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. When treating patients classified as those who have excessive wear without loss of occlusal vertical dimension but with limited space, we could consider treating them at an increased vertical dimension of occlusion. Treatments at an increased vertical dimension of occlusion may provide stability, given that the amount of its increase was minimal, and a perfected occlusion was achieved after enough stabilization period. A 50-year-old male visited the department of Prosthodontics in Yonsei University Dental Hospital with the chief complaint of worn teeth on lower anterior area. Reconstruction at an increased vertical dimension of occlusion was planned. After the compatibility of the new vertical dimension of occlusion had been confirmed under interim fixed restorations, definitive fixed restorations composed of full-contour monolithic zirconia prostheses were placed. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition at an increased vertical dimension of occlusion with an improvement in esthetics and function.

A case of oral rehabilitation using implant fixed prosthesis (skeletal class III malocclusion patient) (골격성 III급 부정교합을 가진 환자에서 임플란트 지지 고정성 보철을 이용한 구강회복 증례)

  • Minjung Kang;Minji Sun;Hong Seok Moon;Jong-Eun Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.125-134
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    • 2023
  • When the patient with class III malocclusion needs extensive oral rehabilitation due to multiple missing teeth, accurate diagnosis, and careful analysis, such as the patient's occlusal relationship, facial changes, and evaluation of the temporomandibular joint are essential. Orthognathic surgery is often performed for aesthetic improvement, depending on the patient's chief complaint. If it is not possible due to certain circumstances, partial aesthetic improvement can be achieved through minimal elevation of the vertical dimension. As this patient may have unexpected issues, such as temporomandibular joint disorder, oral habits like bruxism, and masticatory muscle tension, it was determined whether the patient could adjust to a reversible temporary removable partial denture. After this, the maxillary implant-supported fixed prostheses and the mandibular fixed prostheses were used to achieve stable posterior support and to partially improve the maxillary anterior esthetics. The patient was satisfied with the results both aesthetically and functionally. The prognosis is expected to be good if regular check-ups are conducted.

Complete denture of a skeletal class III patient with occlusal scheme in consideration: A case report (심한 골격성 class III 환자에서 교합양식을 고려한 총의치 수복증례)

  • Lim, Soeun;Kwon, Kung-Rock;Noh, Kwantae;Paek, Janghyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.50-55
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    • 2018
  • Occlusal disharmony is frequently observed among edentulous patients. When artificial teeth come into contact, the unfavorable displacing force may lead to the discomfort, mucosal trauma, or even neuromuscular alterations and emotional disturbances. An optimal occlusal scheme is a critical factor for successful complete dentures. For this case, an edentulous patient with significant interarch size discrepancy due to mandibular prognathism contributing to inadequate function of dentures was treated with complete dentures. The posterior cross-bite tooth setup for compensating the abnormal jaw relations provided a stable and retentive complete denture prosthesis, which was considered adequate by both patient and dentist.

Maxillary anterior prosthetic treatment concerning anterior guidance of a patient who lost stable holding contact (안정적인 교합접촉을 잃은 환자에서의 전방유도를 고려한 치료증례)

  • Park, Jong-Hoon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.467-474
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    • 2019
  • Recently, many patients undergo anterior prosthetic treatment for esthetic reasons. In some patients complain about functional reasons such as inaccurate pronunciation and occlusal discomfort after the treatment. Anterior teeth are important esthetically but in the occlusal point of view, anterior guidance is the second most important factor in occlusion, next to centric relation. Failure to determine an appropriate anterior guidance might lead to posterior occlusal interference, which can highly affect the stability of the posterior teeth. Also, discomfort might occur if the customized interior guidance is not in harmony with the patient's envelope of function. The patient in this case complained of overall discomfort in the maxillary anterior area after prosthetic treatment. The expressed difficulty in pronunciation, unstable occlusion due to lack of stable holding contact and discomfort of the facial muscles. Maxillary anterior prostheses were refabricated through systematic diagnosis and treatment and thus, this case presents esthetical and functional satisfaction to both the patient and the dentist.

Full mouth rehabilitation of a patient with tooth wear and insufficient restorative space due to loss of posterior teeth support: a case report (구치부 지지 상실로 인해 치아 마모와 부족한 수복 공간을 보이는 환자에서의 완전구강회복 증례)

  • Hyunsub Kim;Young-Jun Lim;Ho-Beom Kwon;Myung-Joo Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.72-81
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    • 2024
  • To rehabilitate a patient with inappropriate occlusion due to posterior support loss, it is necessary to achieve an appropriate occlusal vertical dimension and create prostheses that demonstrate stable occlusion at the centric relation for full mouth restoration. This case shows full mouth rehabilitation in a patient with missing posterior teeth and tooth wear, achieved through implant-supported prostheses and zirconia full-veneer crowns. To assess adaptation to the increased occlusal vertical dimension, an occlusal splint and temporary restorations were secured. By fabricating the definitive restorations based on the anterior guidance of the temporary restorations, stable occlusal rehabilitation was successfully achieved.