• Title/Summary/Keyword: 외상성 교합

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Occlusal rehabilitation of post-traumatic malocclusion patient after reduction of panfacial fracture, using selective occlusal adjustment and implant prostheses on centric relation: a case report (다발성 안면 골절의 정복 후 발생한 부정교합 상태의 환자를 중심위에서 선택적 교합 조정 및 임플란트 보철수복으로 교합관계를 회복시킨 증례)

  • Dae-Kyun Kim;So-Young Park;Jung-Jin Lee;Yeon-Hee Park;Kyoung-A Kim;Jae-Min Seo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.204-213
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    • 2023
  • Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.

교합과 저작근 활동

  • Kim, Jung-Su
    • The Journal of the Korean dental association
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    • v.25 no.10 s.221
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    • pp.913-916
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    • 1987
  • 저작운동을 중추신경계와 말초조직의 작용에의해 일생동안 학습과 적응의 가정을 통해 이루어진다. 저작의 양상은 유치가 구강내에 맹출되면서 이루어지며, 상하악 치아의 접촉, 점막과 혀 및 치아상호간에 일어나는 접촉과 치근막의 고유수용기와 악관절 수용기등에 의해 조정되어 최종적으로 에너지소비가 적고 동통이나 불편함이 없이 최대의 효율을 나타내는 양상으로 된다. 그러나 원활한 저작과 하악은동을 이룩하기 위해서는 저작근, 악관절, 상하악 치아의 교합등이 서로 조화를 이루어야 한다. 만일 외상에 의해 악관절의 기능장애가 오면 저작근활동이 변화하고 이에따라 교합장애를 야기한다. 또한 치아를 상실하거나 대합치아간의 조기접촉이 있으면 교합장애가 원인이 되어 근육활동이 변화와 악관절 기능장애를 초래한다. 그리고 때로는 지나친 근육의 활동(이갈이, 지속적 긴장성 수축)에 의해 지나친 치아의 마모로인한 교합장애나 악관절장애를 일으킬 수 있다. 따라서 하악의 기능을 충분히 이해하기 위해서는 교합의 형태학적 관계와 더불어 저작계의 기능적인 면도 고려하여 그 상호관계를 검토하여야 하며 본문에서는 교합에 관련된 저작근의 작용과 이에 영향을 주는 요인 및 교합장애와 근육활동장애의 연관성에 관해 고찰코자 한다.

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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.

Full mouth rehabilitation in patient with loss of vertical dimension and deep bite due to tooth wear (치아 마모로 인한 수직고경감소와 과개교합을 가진 환자의 완전 구강 회복 증례)

  • Chae, Hyun-Seok;Jeon, Bo-Seul;Lee, Jung-Jin;Ahn, Seung-Geun;Seo, Jae-Min
    • 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.

A STUDY ON THE DISTRIBUTION OF PARENTAL CONSULTATION ON THE WEBSITE OF KOREAN ACADEMY OF PEDIATRIC DENTISTRY (대한소아치과학회 홈페이지에 오른 진료상담 내용의 분석)

  • Oh, Young-Jun;Min, Yun-Kyung;Jung, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.439-443
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    • 2002
  • The purpose of this study was to analyze the parental consultation. Also, it was to investigate the tendency divided into different subjects. The subjects were 2142 questions on korean academy of pediatric dentistry homepage. The questions were categorized into 7 subjects, 37 subdivided subjects and children age. The results were as follows: 1. Age group was divided into $0{\sim}6months$, $7{\sim}12months$, $13{\sim}24months$, $25{\sim}36months$, $3{\sim}6years$, $7{\sim}12years$ 12years and over 13 years. $13{\sim}24months$ and $3{\sim}6years$ age group had the largest number of questions. 2. The subject were growth & development, development disturbance & oral disease, behavior management, operative & endodontic treatment, dentition & occlusal guidance, traumatic injury & surgery and etc. Development disturbance & oral disease had the largest number of questions. 3. In subdivided subjects, operative & endodontic treatment showed the most, followed by development & eruption of teeth, traumatic injury, cross-bite, tooth brushing methods in sequence. 4. In age group within subdivided subjects, the most frequent question was neonatal & natal tooth in $0{\sim}6months$, development & eruption of teeth in $7{\sim}12months$, $13{\sim}24months$, operative & endodontic treatment in $25{\sim}36months$, $3{\sim}6years$, time & method of orthodontics in $7{\sim}12years$ and operative & endodontic treatment in over 13years. 5. The questions about cross-bite, traumatic injury and soft tissue disease were distributed evenly in age group.

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