• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.3
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• pp.189-200
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• 2024

In patients with newly established ideal occlusion through full-mouth rehabilitation using fixed prostheses, complications and occlusal changes over time can arise because of various factors. This case report describes a 10-year follow-up of a patient with masticatory dysfunction and aesthetic problems who underwent full-mouth rehabilitation with an increased vertical dimension. During the follow-up, complications such as tooth fracture, occlusal changes, infraocclusion of few implant-supported prostheses, and loss of interproximal contacts were observed. Detecting these issues early through periodic follow-up is important. This case report aims to review the causes of complications after full-mouth rehabilitation using fixed prostheses and the strategies for their management.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.157-170
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• 2021

Loss of posterior bite support might cause unstable occlusal relationship and when the mandible slides forward in the centric or habitual occlusion, excessive load is applied to the anterior region followed by causing the occlusal plane to collapse or leading to a decrease in occlusal vertical dimension. In addition, disorder of temporomandibular joint function may occur. The inter-dental arch discrepancy causes a mismatch in the vertical and horizontal overlap of the anterior and posterior regions. The deep bite in the anterior region and the scissor bite in the posterior region cause unstable occlusal contact and insufficient occlusal contact area. This report was to rehabilitate a patient with above-mentioned complex problems. Physiologic adaptation to increased vertical dimension and new occlusal plane were evaluated using provisional prostheses, and definitive prostheses was fabricated using cross-mounting technique. Stable occlusion, harmonious teeth overlap and adequate occlusal plane were established, so functionally and aesthetically satisfactory results are obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.405-415
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• 2019

Excessive tooth wear can cause irreversible damage to the occlusal surface and can alter the anterior occlusal relationship by destroying the structure of the anterior teeth needed for esthetics and proper anterior guidance. The anterior deep bite is not a morbid occlusion by itself, but it may cause problems such as soft tissue trauma, opposing tooth eruption, tooth wear, and occlusal trauma if there are no stable occlusal contacts between the lower incisal edge against its upper lingual surface. The most important goal of treatment is to form stable occlusal contact in centric relation. In this case report, patients with decrease in vertical dimension and anterior deep bite due to maxillary posterior tooth loss and excessive tooth wear were treated full mouth rehabilitation with increased vertical dimension to regain the space for restoration and improve anterior occlusal relationship and esthetics. The functional and aesthetic problems of the patient could be solved by the equal intensity contact of all the teeth in centic relation (CR), anterior guidance in harmony with the functional movement, and restoration of the wear surface beyond the enamel range.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.444-450
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• 2017

Prosthetic decision-making is complex because of various factors, and involves a combination of the individual dentist's interpretation of the objective clinical data and his or her interaction with the patient. Increasing therapeutic options and emerging outcome data demand the constant re-evaluation of our decision-making process. In this case, fixed prosthetic restorations were selected as a treatment method to reconstruct the occlusal plane of a patient with disharmonious occlusal plane. And the occlusal plane was re-established by establishing a treatment plan through diagnostic wax-up. Provisional restorations obtained by continuous re-evaluation for a sufficient period of time was replicated to definitive restorations using CAD/CAM technology. The results were satisfactory when they were observed through clinical follow-up for 3 months after the end of treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.63-70
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• 2022

Teeth wear with loss of posterior support often leads to symptoms such as irregular occlusal plane and excessive wear of anterior teeth. In such environment, establishing proper posterior support and harmonious anterior guidance and occlusal plane is recommended. In this case, the patient had excessively worn dentition with loss of posterior support, while denying surgical treatment due to her(his) history of osteoporosis, ibandronate injection, and risk of medication-related osteonecrosis of the jaw (MRONJ). To recover the vertical space needed for prosthetic restoration, full mouth rehabilitation with vertical dimension increase of remaining teeth was decided. Missing teeth in the posterior area were restored with mandibular removable partial denture. The treatment plan was determined through careful diagnosis, and every step of procedures including tooth preparation, provisional phase with the increased vertical dimension, and definitive prosthetic phase were carried out accordingly. Once the treatment was completed, the patient was satisfied functionally and esthetically. Periodic examination of oral hygiene, occlusal stability was conducted.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.273-279
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• 2016

Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.33-43
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• 2023

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.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.33-38
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• 2013

Occlusal plane is a sagittal expression of dental arch form, and it composes the shape of occlusion, which is one of the most important elements of Maxillo-oral system. In this case, vertical, horizontal coordinates of bionic-median-sagittal plane was produced in articulator, and to achieve relation of left and right position of upper, lower teeth and deficits in alveola, Shilla system was used to reconstruct occlusal plane. In this case, a 41 year-old male patient visited for fracture of 10 unit metal-ceramic fixed partial denture of upper anterior teeth and for overall treatment. Clinical, radiographical, model examination was held, full mouth rehabilitation was achieved by placing dental implant. Maxillo-oral relation was recorded using Gothic arch Tracer complex and were mounted. And for the next step, we estimated original occlusal plane using Shilla system. After analysis we produced diagnosis wax pattern. On the basis of this, radiography stent was manufactured and dental implant was placed, and temporary prosthesis was made by using diagnosis wax pattern. Cross mounting and anterior guiding table were performed in order to reproduce temporary restoration morphology and bite pattern, followed by final restoration made of all ceramic crown with zirconia coping. As stated above, appropriately esthetic and functional results can be seen in using Shilla system in diagnosis and treatment procedure of full mouth rehabilitation patient.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.3
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• pp.218-226
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• 2018

In partial edentulous patients, implant-assisted removable partial denture which provide additional retention and support by placing a small number of implants in strategic positions might be suitable treatment. This case of patient with loss of maxillary posterior teeth and moderate to severe wear of residual dentition, three implants were placed in the maxillary anterior edentulous area and then surveyed bridges were made including remaining anterior natural teeth. Posterior edentulous area was restored with distal extension removable partial denture (RPD). In addition, the worn mandibular natural teeth were restored with fixed prostheses. As a result, reduced vertical dimension and collapsed occlusal plane were rehabilitated, and improved functionally and aesthetically. The purpose of this case was to report the results of three-year follow-up of full mouth rehabilitation with anterior implant surveyed bridges and distal extension RPD.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.160-178
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• 2023

Diagnosis and analysis of occlusal relationships are important factors in prosthetic treatment. A thorough occlusion analysis and evaluation should be performed before treatment to restore a stable interocclusal relationship. Analysis and evaluation are essential during the treatment process and at regular follow-ups. Recently, with the development of dental equipment and digital processing methods, new quantitative analysis methods that can record the patient's occlusal relationship have been introduced. Among them, the T-Scan Novus (Tekscan Inc., S. Boston, MA, USA) displays the strength of the initial contact point and the occlusal contact point of the teeth using a pressure sensor. With this, occlusal contact time of the teeth, anteroposterior and left-right balance of occlusal force can be compared. The Dental prescale II (GC Co., Tokyo, Japan) scans the occlusal contact point using a pressure-sensing film and analyzes the density of the contact point. It can measure the distribution and strength of the occlusal force of the teeth in the most natural occlusion state. Based on this, appropriate prosthetic treatment (four-unit fixed partial denture, removable partial denture, complete denture, and complete oral restoration cases) was performed according to the area and extent of the patient's tooth loss. The patient's occlusion at the first visit, treatment stage, right after treatment, and regular follow-up were compared and evaluated using a quantitative method for appropriate occlusion analysis using T-Scan Novus and Dental prescale II. This report enhances the understanding of occlusion analysis during prosthetic restoration. The results satisfied both the clinician and patients in terms of function and aesthetics.