• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.2
• /
• pp.153-160
• /
• 2020

Gradual tooth wear is a natural process of aging, but pathological wear over physiologic ranges leads to functional and esthetic problems. The loss of posterior support may cause pathological wear of anterior teeth, which results in reduction of vertical dimension and disharmony of occlusal plane. To solve this problem, determination of proper vertical dimension considering centric relation is necessary. This case report presented 71-year-old male, who had the severe wear of lower anterior teeth due to loss of posterior support. By meticulous evaluation, a full mouth rehabilitation with elevation of vertical dimension was planned. After 8 months of follow-up, stable occlusal scheme is maintained and patient was satisfied with clinical outcome functionally and esthetically.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.38 no.1
• /
• pp.60-68
• /
• 2022

A patient with severe periodontitis has causative factors that cause pathological tooth movement, the occlusion is disintegrated, and the vicious cycle of worsening periodontitis is repeated. In particular, when pathological tooth movement occurs in the maxillary anterior region, the patient has an aesthetic sense of atrophy, and the quality of life was reduced. Therefore, when orthodontic treatment was added to patients with severe periodontitis, it promotes the formation of new bone, reduces periodontal cysts, and obtains clinical attachment, which leads to favorable results in prosthetic restoration, thereby enabling ideal occlusion, function and aesthetics. Periodontal treatment, orthodontic treatment, natural tooth restoration, and implant prosthesis were planned for patients with pathological tooth movement in the anterior region due to loss of occlusal support in the posterior region. As a result, an ideal restoration space was secured, a stable restoration of occlusal contact was formed, and the maxillary anterior teeth were aesthetically improved.

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

• The Journal of Korean Academy of Prosthodontics
• /
• v.61 no.3
• /
• pp.215-226
• /
• 2023

Severe wear of the anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. Additionally, when treating patients with collapsed occlusion due to multiple tooth loss and tooth wear, it is important to determine the presence of vertical dimension loss through accurate clinical and radiographic examinations and diagnostic wax-up. The patient of this case is a 44-year-old female patient who complained of overall tooth wear and loss of posterior teeth due to bruxism and clenching habits, visited the hospital with the address of restoring masticatory function and improving aesthetic appearance through prosthetic treatment. Through model analysis and diagnostic wax-up, an increase in vertical dimension was determined, and full mouth restoration with fixed prostheses was planned. The degree of adaptation to the vertical dimension was confirmed step by step using an occlusal splint designed with CAD (Computer aided design) software and 3-D (3-Dimensional) printed, and then restored with provisional restoration and after a 4-month adaptation period, the entire dentition was restored with metal ceramic crowns and implants. Through this procedure, satisfactory treatment results were obtained in terms of function and aesthetics.

• The Journal of Korean Academy of Prosthodontics
• /
• v.62 no.2
• /
• pp.165-173
• /
• 2024

Restoring lost teeth is very important in terms of both function and aesthetics. If tooth loss occurs in the posterior region and the loss of support is persistent, it may cause a gradual shift in the position of the mandible and a change in occlusion. This clinical case attempted to restore support for the posterior teeth with a fixed prosthesis using implants in a patient whose opposing teeth were erupted and the occlusal plane collapsed due to long-term loss of the maxillary left posterior teeth and mandibular right first molars. To correct the occlusal plane of remaining dentition, wax-up of maxillary left posterior teeth was duplicated with acrylic resin and placed on maxilla. Surgical template for implant placement were fabricated using digital technology. After the support of the posterior teeth was restored with the placement of the implant, stable occlusion with temporary restorations was observed for a sufficient time. Afterwards, monolithic zirconia prosthesis was placed on the patient to ensure functional and aesthetic improvement.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.35 no.4
• /
• pp.260-269
• /
• 2019

The prolonged neglect of the posterior teeth missing area may cause mesial drift, extrusion, unexpected movement of the adjacent teeth and alveolar bone loss with occlusion collapse. Therefore it is recommended to treat that area by the prosthesis as soon as possible after tooth missing. However, if orthodontic treatment is applied to move the remained teeth, it can create improved biomechanical dentoalveolar environment. The use of the third molars in teeth missing area provides advantages as optimizing of prosthesis size. However, crown shape, location, soundness of the third molar and possible of eruption failure should be considered. In this case report, two patients closed a second teeth missing site and reduced the size of the first and second teeth missing area for an implant by protraction of impacted third molars. This case reports the considerations for closing or reducing the posterior teeth space with protracting the third molars by comparing two patients.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.1
• /
• pp.63-70
• /
• 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
• /
• v.58 no.1
• /
• pp.50-57
• /
• 2020

The loss of posterior support and the abnormal jaw relation can cause pathologic findings. If deep bite patients with multiple missing teeth, can not have the stable posterior contact, the mandible moves posteriorly, and consequently the overjet and overbite get worse. And when the mandibular irregular occlusal plane is corrected, it is easier to have the bilateral balanced occlusion with the maxilla. So the treatment goal is to give proper posetrior support and establish appropriate anterior guidance, and ultimately provide improved mastication and esthetics recovery. In this case, a 68 year old man, having deep bite without posterior support was evaluated by the vertical dimesion decision flow-chart. An available prosthetic height, anterior occlusal relation such as overjet, overbite and the esthetic part such as facial height and the cephalometric analysis are the factors to be considered.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.4
• /
• pp.369-377
• /
• 2020

Gradual teeth wear is normal physiological progress, severe tooth wear can causes dysfunction, occlusal plane disharmony and esthetic problems. If additional space is needed for prosthetic restoration due to severe attrition, full mouth rehabilitation with increase of occlusal vertical dimension may be considered. In this case, 72 year old male patient with severe worn dentition, irregular gingival zenith and deep anterior bite was treated by full mouth rehabilitation for regaining the space for restoration, improving relationship and esthetic of anterior teeth. Provisional restoration obtained by systemic analysis, diagnosis and re-evaluation for a sufficient time was replicated to final restorations through double scanning technique using monolithic zirconia blocks. Satisfactory functional and esthetic outcomes were obtained.

• The Journal of Korean Academy of Prosthodontics
• /
• v.62 no.1
• /
• pp.72-81
• /
• 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.