• Title/Summary/Keyword: Occlusal guidance

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Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition: A case report (과도한 치아 마모를 보이는 환자에서 수직고경 증가를 동반한 전악 수복 증례)

  • Kim, Dae-Sung;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Lee, Hyeonjong;Lee, So-Hyoun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.210-219
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    • 2021
  • Excessive teeth wear can lead to reduced chewing efficiency, occlusal plane collapse, and facial changes. Full mouth rehabilitation with a change in vertical dimension may cause pain in the temporomandibular joint, masticatory muscle and teeth, so an accurate diagnosis and treatment plan is required. In this case, a 69-year-old man had excessive teeth wear with a loss of posterior support. We evaluated the degree of adaptation to the increased vertical dimension with the removable occlusal splint and provisional restoration. We report this case because the treatment result has been functionally and aesthetically satisfactory by providing stable anterior guidance, proper posterior teeth disclusion, and even contact of all teeth in centric occlusion.

Prosthetic full mouth rehabilitation of patient with mandibular prognathism and asymmetry: a case report (하악의 전돌 및 비대칭을 가진 환자에서 보철적 전악 구강회복 증례)

  • Jaeyeong Lim;Hwa-Jeong Lee;Jong-Eun Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.28-37
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    • 2024
  • Severe cases of mandibular prognathism can be treated with orthodontic therapy or surgical correction, but there are situations where only prosthetic improvement is possible. An understanding of class III patients is needed, including a vertical chewing pattern and the absence of anterior guidance. Additionally, it is relatively easy to increase occlusal vertical dimension to correct the anterior crossbite, but this approach can sometimes lead to unfavorable results, necessitating careful diagnosis and treatment planning. In this case report, oral rehabilitation was conducted in a patient with mandibular prognathism and asymmetry, utilizing implants and fixed dental prosthesis. Through a step-by-step treatment approach, the existing occlusal vertical dimension was maintained, and the final fixed dental prosthesis restoration was completed. Accordingly, it shows functional and aesthetically appropriate results, and reports on the patient's diagnosis and treatment process.

Rehabilitation using twin-stage method for a Sjögren's syndrome patient with severe discoloration and attrition on upper and lower anterior teeth (상하악 전치부 심한 변색과 마모를 보이는 쉐그렌 증후군 환자에서 twin-stage법을 이용한 수복증례)

  • Lee, Seon-Ki;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.291-297
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    • 2016
  • Patients with $Sj{\ddot{o}}gren^{\prime}s$ syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a $Sj{\ddot{o}}gren^{\prime}s$ syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.

Ankylosed Primary Molar and Eruption Guidance of Succeeded Permanent Premolar : Case Reports (유착된 유구치와 후속 영구 소구치의 맹출 유도 : 증례보고)

  • Jang, Hayoung;Oh, Sohee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.99-107
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    • 2017
  • In the management of ankylosed primary molars, early diagnosis, proper treatment, and thorough follow-ups are very important. Untreated infraocclusion due to ankylosis has a negative impact on normal occlusal development, and may cause problems. There are many treatment options on infraoccluded deciduous molars, such as periodic observation, conservative method, restoration, and space regaining via extraction of the teeth. In this case report, two 6-year-old girls were diagnosed with ankylosed maxillary second primary molar and displaced tooth germ of the second premolar. Early surgical removal of the ankylosed primary molar was considered as a treatment approach. The long-term follow-up shows normal eruption of a succeeded permanent premolar.

Factor Affecting Mandibular Rotational Troque Movements (하악의 비틀림회전운동에 영향을 미치는 요인)

  • 이유미;한경수;허문일
    • Journal of Oral Medicine and Pain
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    • v.23 no.2
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    • pp.143-155
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    • 1998
  • This study was performed to investigate the factor that might affect mandibualr body rotation. For the study, 115 patients with temporomandibular disorders and 35 dental students without angy signs and symptoms of temporomandibular disorders were randomly selected as the patient group and the contreol group, respectively. Preferred chewing side, Angle' classification, lateral guidance pattern, and affected side were clinically recorded, and the amount of Mandibular body rotational torque movement was measured in wide opening and closure, in right and left excursion with vertical and lateral distance in frontal plane, right and left rotational angel in horizontal and in frontal plane. Masticatory muscle activity of anteriorocclusal contact pattern on maximal hard biting were also observed synchronously with BioEMG and T-Scan , respectively. The observed items were muscle activity of anterior temporalis and superficial masseter, and tooth contact status related to contact number, force, duration, and occlusal unbalance between right and left arch. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Mean value of vertical distance in frontal plane in wide opening and closure was more in control subjects than in patients, but there was no difference for rotational angle. In right excursion, rotational angles were greater in patient group than in control group. 2. Comparison among the subjects by preferred chewing side did not reveal any significant difference, but comparison among patients by affected side showed more rotational amount in bilaterally affected patients than in unilaterally affected patients. 3. Comparison among the subjects by Angle's classification or lateral guidance pattern revealed no difference. There was also no difference between preferred chewing side and contralateral side, and between affected side and contralateral side. 4. Positive correlation in madibular rotational torque movements were observed among vertical distance, total horizontal rotation angle, electromyographic activity of anterior temporalis, tooth contact number, and tooth contact force but total frontal rotation angle almost did not show any correlation with other variables except vertical distance.

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Full mouth rehabilitation on the patient with deep bite and posterior bite collapse using re-establishment of occlusal vertical dimension (구치부 교합 지지 상실과 전치부 과개 교합을 가진 환자의 교합 재설정을 통한 구강 회복 증례)

  • Jang, Woo-Hyung;Jo, Yu-Jin;Lim, Hyun-Pil;Yun, Kwi-Dug;Park, Sang-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.50-57
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    • 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.

Full mouth rehabilitation in osteoporosis patient with loss of teeth and excessive wear (치아 상실과 심한 마모를 보이는 골다공증 환자에서의 완전구강 회복 증례)

  • Kim, Hyun-Tack;Kim, Myung-Joo;Lim, Young-Jun;Kwon, Ho-Beom
    • 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.

A case of oral rehabilitation with increasing vertical dimension for a patient with loss of posterior teeth support (구치부 지지 상실을 보이는 환자에서 수직고경 거상을 동반한 구강 회복 증례)

  • Kim, Hyun-Hwi;Lee, Jong-Hyuk;Ha, Seung-Ryong;Choi, Yu-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.404-411
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    • 2022
  • The patient in this case was an 80-year-old female who had lost #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 teeth. The patient showed loss of posterior support, loss of vertical dimension of occlusion, and deep anterior overbite. Her chief complaint was esthetic and functional discomfort. She wanted to restore normal facial aesthetic shape and masticatory function through prosthetic treatment. Clinical evaluation, radiographic examinations, and facial and oral analysis were performed. Interocclusal rest space was excessive than the average. Distance between labial vestibules and zenith of central incisors, and lower facial ratio were below the average. Taken together, occlusal rehabilitation was determined through increasing 4 mm of vertical dimension on premolars. In this case, a patient who lacked restoration space with deep bite in the anterior region due to loss of the posterior teeth support restored a stable occlusal relationship and harmonious anterior and lateral guidance through fixed and removable prosthesis with increased vertical dimension.

Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report (악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례)

  • Sang-Myeong Tak;Chang-Mo Jeong;Jung-Bo Huh;So-Hyoun Lee;Mi-Jung Yun
    • 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.

Rehabilitation with minimal increase in occlusal vertical dimension in a patient with excessive tooth wear and edge-to-edge bite (과도한 치아 마모와 절단교합을 보이는 환자에서 최소한의 수직 고경 증가를 통한 구강회복 증례)

  • Hee-Young Kim;Seong-A Kim;Yong-Sang Lee;Keun-Woo Lee;Joo-Hyuk Bang
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.143-152
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    • 2023
  • Although tooth wear is a normal process due to aging, severe tooth wear causes various complications such as increased tooth sensitivity, loss of tooth structure, and pulp complications. In the treatment of patients with excessive tooth wear, the evaluation of loss of vertical occlusal dimension should be prioritized. If it is necessary to increase the vertical dimension to secure the restoration space, it is important to establish a treatment plan with the comprehensive analysis and determine the minimum vertical dimension elevation. In this case, 66-year-old male patient with severe worn dentition wanted to restore masticatory function and improve esthetic restoration. In order to determine the appropriate vertical dimension of the patient, we evaluated oral examination, radiographic examination, and diagnostic cast examination, and performed rehabilitation with minimum vertical dimension elevation. As a result of observation for 8 months, the definitive prosthesis was completed with contact of all teeth in centric occlusion, and proper anterior/posterior guidance. Through the above process, satisfactory aesthetic and functional outcomes were obtained.