• Title/Summary/Keyword: Occlusal changes

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Full mouth rehabilitation of iatrogenic attrition patient (의원성 마모 환자의 전악 수복 증례)

  • Lim, Na-Kyung;Shin, Soo-Yeon
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.228-237
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    • 2021
  • Physiologic tooth attrition is accepted as a natural change. But when pathologic changes, such as loss of occlusal vertical dimension, masticatory pain, loss of masticatory function, and loss of esthetics occur, restorative measures should be taken by dentist. A patient visited the clinic with the chief complaint of 'My lower teeth bite the palate and it hurts'. It was diagnosed as iatrogenic attrition of lower natural dentition caused by inappropriate upper restorations, resulting in traumatic overbite. Through model analysis and diagnostic wax up, increase in vertical dimension was decided. Upper and lower dentitions were restored with new prostheses. After restoration, satisfactory outcomes were achieved both in functional and esthetic aspects.

Spatial changes of the upper dentition following en-masse space closure: A comparison between first and second premolar extraction (En-masse 견인에 의한 발치공간 폐쇄 후 상악치열의 이동양상 -제1소구치 및 제2소구치 발치 비교)

  • Kim, Hui-Jung;Chun, Youn-Sic;Jung, Sang-Hyuk
    • The korean journal of orthodontics
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    • v.35 no.5 s.112
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    • pp.371-380
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    • 2005
  • The purpose of this experimental study was to evaluate aㅜd compare maxillary arch dimensional and positional changes between first and second premolar extraction groups. The Calorific Machine was used to illustrate tooth movement in three dimensions. The experimental teeth except the first or second premolars were embedded in artifical alveolar bone. The extraction space was closed using arch wires with bull loops into which 15 degree gable bends were placed. Before and after space closure, radiographs were taken in the sagittal and occlusal directions using occlusal films. The results showed greater mean maxillary incisor retraction and less anchorage loss in the maxillary first premolar extraction group than in the maxillary second premolar extraction group. Mesiopalatal rotation of anchor teeth was greater after extraction of a maxillary second premolar than a maxillary first premolar (P<.001).

Distortion of tooth axes on panoramic radiographs taken at various head positions (두부 위치 변화에 따른 파노라마 방사선사진상의 치축각도의 왜곡)

  • Jeon, Hyun-Sang;Choi, Gab-Lim;Lim, Sung-Hoon;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.240-251
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    • 2008
  • Objective: The purpose of this study was to evaluate the effect of head position changes on the root parallelism between adjacent teeth on panoramic radiographs. Methods: A model with normal occlusion was constructed in the SolidWorks program, then RP (rapid protyping) model was fabricated. The model was repeatedly imaged and repositioned five times at each of the following nine positions: ideal head position, $5^{\circ}$ up, $10^{\circ}$ up, $5^{\circ}$ down, $10^{\circ}$ down, $5^{\circ}$, right, $10^{\circ}$, up, and $5^{\circ}$ right rotation, $10^{\circ}$ right rotation. Panoramic radiographs were taken by Planmeca ProMax and the angle between the long axes of adjacent teeth was directly measured in the monitor. Results: Axes of adjacent teeth tended to converge toward the occlusal plane when the head tilted up and converged in the opposite direction to the occlusal plane when the head tilted down. Anterior teeth showed the most notable differences. When one side of the head tilted up $5^{\circ}$ and $10^{\circ}$ along the anteroposterior axis (Y axis), tooth axes of the same side tended to converge toward the occlusal plane and tooth axes of the opposite side tended to converge in the opposite direction to the occlusal plane. When the head rotated to one side along the vertical axis (Z axis), the canine and lateral incisor of the same side converged in the opposite direction to the occlusal plane and the canine and lateral incisor of the other side converged toward the occlusal plane. Conclusions: When assessing the root parallelism on panoramic radiographs, the occlusal plane cant (anteroposterior or lateral) or asymmetry of the dental arch should be considered because these can cause distortion of tooth axes on panoramic radiographs.

Stress Analysis on the Supporting Bone around the Implant According to the Vertical Bone Level (치조골 높이가 다른 임프란트 주위 지지골 응력분석)

  • Boo, Soo-Boong;Jeung, Jei-Ok;Lee, Seung-Hoon;Kim, Chang-Hyun;Lee, Seung-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.1
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    • pp.55-68
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    • 2007
  • The purpose of this study was to analyze the distribution of stress in the surrounding bone around implant placed in the first and second molar region. Two different three-dimensional finite element model were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$) on the second molar region. A mandibular segment containing two implant-abutments and a two-unit bridge system was molded as a cancellous core surrounded by a 2mm cortical layer. The mesial and distal section planes of the model were not covered by cortical bone and were constrained in all directions at the nodes. Two vertical loads and oblique loads of 200 N were applied at the center of occlusal surface (load A) or at a position of 2mm apart buccally from the center (load B). Von-Mises stresses were analyzed in the supporting bone. The results were as follows; 1. With the vertical load at the center of occlusal surface, the stress pattern on the cortical and cancellous bones around the implant on model 1 and 2 was changed, while the stress pattern on the cancellous bone with oblique load was not. 2. With the vertical load at the center of occlusal surface, the maximum von-Mises stress appeared in the outer distal side of the cortical bone on Model 1 and 2, while the maximum von-Mises stress appeared in the distal and lingual distal side of the cortical bone with oblique load. 3. With the vertical load at a position of 2 mm apart buccally from the center, there was the distribution of stress on the upper portion of the implant-bone interface and the cortical bone except for the cancellous bone, while there was a distribution of stress on the cancellous bones at the apical and lingual sides around the fixture and on the cortical bone with oblique load. 4. With the changes of the supporting bone on the second molar area, the stress pattern on the upper part of the cortical bone between two implants was changed, while the stress pattern on the cancellous bone was not. The results of this study suggest that establishing the optimum occlusal contact considering the direction and position of the load from the standpoint of stress distribution of surrounding bone will be clinically useful.

Effect of cooling water temperature on the temperature changes in pulp chamber and at handpiece head during high-speed tooth preparation

  • Farah, Ra'fat I.
    • Restorative Dentistry and Endodontics
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    • v.44 no.1
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    • pp.3.1-3.10
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    • 2019
  • Objectives: It was the aim of this study to evaluate the effect of cooling water temperature on the temperature changes in the pulp chamber and at the handpiece head during high-speed tooth preparation using an electric handpiece. Materials and Methods: Twenty-eight intact human molars received a standardized occlusal preparation for 60 seconds using a diamond bur in an electric handpiece, and one of four treatments were applied that varied in the temperature of cooling water applied (control, with no cooling water, $10^{\circ}C$, $23^{\circ}C$, and $35^{\circ}C$). The temperature changes in the pulp chamber and at the handpiece head were recorded using K-type thermocouples connected to a digital thermometer. Results: The average temperature changes within the pulp chamber and at the handpiece head during preparation increased substantially when no cooling water was applied ($6.8^{\circ}C$ and $11.0^{\circ}C$, respectively), but decreased significantly when cooling water was added. The most substantial drop in temperature occurred with $10^{\circ}C$ water ($-16.3^{\circ}C$ and $-10.2^{\circ}C$), but reductions were also seen at $23^{\circ}C$ ($-8.6^{\circ}C$ and $-4.9^{\circ}C$). With $35^{\circ}C$ cooling water, temperatures increased slightly, but still remained lower than the no cooling water group ($1.6^{\circ}C$ and $6.7^{\circ}C$). Conclusions: The temperature changes in the pulp chamber and at the handpiece head were above harmful thresholds when tooth preparation was performed without cooling water. However, cooling water of all temperatures prevented harmful critical temperature changes even though water at $35^{\circ}C$ raised temperatures slightly above baseline.

Soft tissue changes associated with ASO/BSSRO and Le Fort I/BSSRO in skeletal Class III malocclusion with upper lip protrusion (상순돌출을 동반한 골격성 III급 부정교합에서 수술방법에 따른 치료 후 상악 연조직 변화 - ASO/BSSRO와 Le Fort I/BSSRO 비교)

  • Kang, Ju-Man;Kim, Yoon-Ji;Park, Je-Uk;Kook, Yoon-Ah
    • The korean journal of orthodontics
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    • v.40 no.6
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    • pp.383-397
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    • 2010
  • Objective: The objective of this study was to compare maxillary soft tissue changes and their relative ratios to hard tissue changes after anterior segmental osteotomy (ASO)/bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I/BSSRO in skeletal Class III malocclusion with upper lip protrusion. Methods: The study sample comprised the ASO/BSSRO group (n = 14) and the Le Fort I/BSSRO group (n = 15). The Le Fort I/BSSRO group included cases of maxillary posterior impaction only. Lateral cephalograms were taken 2 months before and 6 months after surgery. Linear and angular measurements were performed. Results: The anterior maxilla moved backward in both groups after surgery, however the amount of change was significantly larger in the ASO/BSSRO group (p < 0.01). The ratios of hard to soft tissue change were 79% (SLS to A point), 80% (LS to A point) in the ASO/BSSRO group, and 15% (SLS to A point), 68% (LS to A point) in the Le fort I/BSSRO group. In addition, there was a $3.23^{\circ}$ increase of the occlusal plane in the Le Fort I/BSSRO group. Conclusions: When two-jaw surgery is indicated in skeletal Class III patients with protrusive lips, ASO may be a treatment of choice for cases with more severe upper lip protrusion, while Le Fort I with posterior impaction may be considered if an increase of occlusal plane angle is required.

A STUDY OF CONDYLAR POSITIONAL CHANCES BEFORE & AFTER STABILIZATION SPLINT THERAPY (교합안정장치 사용 전, 후의 하악과두 위치 변화에 관한 연구)

  • Lee, Suk-Kyung;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.28 no.1 s.66
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    • pp.113-122
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    • 1998
  • Stabilization splint therapy Precedes orthodontic intervention to enable the operator to find a 'true' centric(which is stable and comfortable), to test the patient's response to a change in the occlusion, prior to embarking upon a complex course of occlusal therapy : and finally, to see if the centric relation position can be stabilized. For this study, 47 malocclusion Patients enrolled for orthodontic treatment at the Department of Orthodontics, College of Dentistry, Chosun University comprised the malocclusion group, little variation of growth factor by the second molar eruption. They had Cr-Co discrepancy beyond normal range. For each patients the stabilization splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in CR and CO were measured using Penadent articulators, Panadent condylar position indicator(CPI), and transcranial projection before & after stabilization splint therapy. On the basis of this study, the results of this study were as follows 1. In all samples using CPI, there were statistical significances in CR-CO discrepancy(p<0.001) both before 8t after stabilization splint therapy. 2. In Rt and Lt+Rt/2 of superior joint space using transcranial projection, there were statistical significances in CR-CO discrepancy({<0.05) before & after stabilization splint therapy. 3. In supero-inferior components using CPI, there were statistical significances in CR-CO discrepancy(p<0.01) before & after stabilization splint therapy. 4. In all components except Rt using transcranial projection, there were no statistical significances in CR-CO discrepancy(p>0.05) before & after stabilization splint therapy. To sum up, CPI might be more effective than transcranial projection to reveal the changes between CR-CO discrepancies and stabilization splint might be more useful appliance for displaying the vertical changes, than the antero-posterior changes, of condylar position.

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Maxillary full-arch fixed dental prosthesis of the elderly patient with worn dentition (마모된 치열을 지닌 고령 환자의 상악 전악 고정성 수복 증례)

  • Lee, Jae hyun;Choi, Yeon jo;Ryu, Jae jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.2
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    • pp.154-162
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    • 2017
  • Tooth wear, one of the physiological changes in the elderly patient's mouth, generally does not require treatment, but requires prosthodontic restoration when occlusal disharmony, poor masticatory function, pulp exposure occurs. One of the primary considerations in prosthodontic restoration for tooth wear is vertical dimension. It is necessary to make an accurate diagnosis and analysis, correct judgement of the interdental relationship for predictive treatment plan. A step-by-step approach considering dental care for aged is also required. In this case, a 93-year-old male patient presented with worn dentition and mobility of existing fixed dental prosthesis. After diagnosis and evaluation, maxillary rehabilitation without any change in the occlusal vertical dimension was performed and this shows satisfactory results both functionally and morphologically.

Study on Characteristics of Maxillofacial Growth in Class III Malocclusion Patients by Cranial Base Growth (3급 부정교합 환자에서 두개저 성장 양상에 따른 악골 성장 특성에 관한 연구)

  • Son, Do-Kyoung;Park, Sung-Won;Lee, Jae-Min;Kim, Eun-Ja;Choi, Sang-Mun;Kim, Young-Woon;Choi, Mun-Gi;Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.483-489
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    • 2011
  • Purpose: Craniofacial structure form results from the adaptation to morphologic and functional changes in their neighboring structures for a mutual balance. The purpose of this study is classification of maxillomandibular complex growth pattern follow by cranial base growth pattern. And this study is identifying the correlation between maxilla-mandibular complex growth pattern and orthodontic criteria. Methods: 142 Class III malocclusion patients had orthognathic surgery at Wonkwang University Dental Hospital during April 2004 to October 2010. Patients were divided into 4 groups and the correlation between cranial base and maxillomandibular growth patterns were evaluated. Results: There was a correlation between cranial base and maxillomandibular growth patterns. Positive relationships were found between the occlusal plane, Incisor mandibular plane angle, mandibular plane, positioning of pogonion and the saddle angle, indicating maxillary growth patterns. Negative relationships were found between SNA, SNB, maxillary incisor angle and saddle angle. Positive relationships were found between the ratio of the anterior and posterior cranium, positioning of pogonion and the percentage of cranial depth indicating mandibular growth patterns. Negative relationships were found between the occlusal plane, maxillary incisor angle, mandibular plane, mandibular angle and cranial depth. Conclusion: Cranial base and maxillofacial growth patterns were correlated and the classification should be adjusted before orthognathic surgery.

Effect of Gum-Chewing on Facial Appearance and Stomatognathic System

  • Kim, Joo-Hwan;Park, Hae-Seo;Kim, Moon-Young;Kim, Kyung-Wook
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.16-24
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    • 2014
  • Purpose: This study was planned to clarify a negative view of chewing gum due to the concern that continuous gum chewing might cause a change in the gonial angle and make the lower facial appearance look square. Materials and Methods: We had 25 adults (13 males and 12 females, with an average of 27.3 years) chew 6 g of gum (spearmint) evenly with both right and left posterior teeth for one hour per day for three months. We then measured their gonial angle, the inclination of occlusal plane, facial height, bone marrow density, and masticatory force before chewing, 1, 2, and 3 month after chewing to verify its significance statistically. Result: The results showed that the gonial angle increased from $122.7^{\circ}$ to $123.3^{\circ}$ (P>0.05), and thus the jaws became slightly slimmer. There was no change in the occlusal plane inclination and facial height. Meanwhile bone marrow density in the mandibular angle and ascending ramus increased from $0.285g/cm^2$ to $0.290g/cm^2$ (P<0.05), and masticatory force also increased by 0.5 kg on the right side and 0.8 kg on the left side (P<0.05). Conclusion: Continuous chewing of gum gives an appropriate exercise effect to the stomatognathic system. As chewing gum has effect on increase bone marrow density without changing the mandibular angle and facial appearance the claim that jaw bone changes to a square jaw through chewing gum is regarded to be groundless.