• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 2022

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.284-292
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• 2023

Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.

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

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.262-272
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• 2015

Loss of molar support and abnormal jaw relationship lead to occlusal disharmony and cause pathologic signs. Full mouth rehabilitations with reestablishment of occlusal schemes are needed. In this case, the 75 year-old female patient showed posterior bite collapse, irregular occlusal plane and Class II jaw relationship. By observing her profile and interocclusal distance, she was diagnosed as loss of occlusal vertical dimension. Treatment plan is to restore maxillay class I removable partial denture and mandibular fixed prosthesis and to establish vertical dimension and harmonious occlusal plane. Occlusal vertical dimension of 19 mm, which is obtained by 7.5 mm increase between maxillary right lateral incisor and mandibular canine, was established using temporary prosthesis via diagnostic wax-up. Patient adaptation with newly formed vertical dimension was verified during 8 week follow-up period. Within the information of interim prostheses, final restoration was constructed and delivered. The patient showed sound occlusal scheme and esthetic profile.

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

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

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.1
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• pp.70-76
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• 2018

Excessive tooth wear can lead to decrease in occlusal vertical dimension and can cause pathological changes in the oral environment and masticatory system. When recovering occlusal vertical dimension and occlusion, accurate diagnosis and analysis are essential. This clinical case describes a 75-year-old woman with severely worn dentition due to loss of the posterior support. Full mouth rehabilitation with occlusal vertical dimension increment was planned. Clinical and radiographic examinations, occlusal vertical dimension evaluation, and diagnostic wax-up were performed and patient adaptability was evaluated using provisional restorations. As for definitive restoration, considering economic condition of the patient, removable partial denture was fabricated and solitary implants were placed in the mandibular left and right posterior region to increase support and retention of the removable partial denture. During one year of follow-up, functional and esthetic outcomes were observed satisfactory.

• 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.

• 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.

• 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.