• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.214-223
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• 2016

Implant-assisted removable partial denture (Implant-assisted RPD, IARPD), posterior edentulous extension areas of which obtains additional support and retention from implants, is attracting increasing interest. This case report presents a successful treatment on a partially edentulous patient with a severely canted occlusal plane resulted from a long-term use of posterior extended RPD. The full mouth was rehabilitated through a fixed prosthesis on maxilla and IARPD with zirconia occlusal surface on mandible, which allowed to achieve an esthetic occlusal plane with long-term stability and, ultimately, functionally satisfying outcome.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.3
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• pp.247-256
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• 2003

The patient had bruxism and epilepsy tendency. Inadequate or unstable posterior support was identified due to severe anterior attrition and decreased occlusal vertical dimension. Prematurities of posterior occlusal and wear facets increased the function of anterior teeth, resulting in severe wear. Wear facets displayed sharply defined peripheries, which are matched on articulated diagnostic casts. Also the patient showed C III malocclusion tendency, and lost some facial contour with drooping corners on the mouth. In this case, the alteration of OVD (Occlusal Vertical Dimention) may provide a biologically compatible adjunct to the treatment such as dentofacial esthetics, improved visual proportion in facial heightand mechanical solutions to the force-management of the masticatory system. The patient requires extensive restorative treatment to regain appropriate function, esthetics and comfort. According to the report by Farhad Fays, the average vertical distance from the maxillary to the mandibular mucolabial reflection in the region of the central incisors is approximately 34mm. However, the vertical distance of this patient was found to be 32mm, which was necessary to add gauge 20-sheets to apply vertical dimension. A removable occlusal overlay splint, which restores OVD to the estimated optimalposition, is the general first trial. The patient was observed periodically for 6 weeks, while appropriate adjustments were made vertical dimension to function. When patient felt comfortable with the splint, the teeth were prepared, and provisional restorations are placed for 3 months. The provisional restoration was fabricated by a diagnostic wax-up. When the patient felt comfortable with the provisional restoration, the final restoration mimics OVD, function, and esthetics that have been developed in the treatment restorations. Restoration of the extremely worn dentition presents a substantial challenge to thedentists. Therefore, careful evaluation of the etiology, history, and factors associated with occlusal vertical dimension should be preceded prior to the appropriate treatment planning.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.477-482
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• 2010

In a case of multiple posterior teeth loss, antagonistic teeth extrude to the edentulous space and compensatory occlusion on the remained anterior teeth leads to occlusal trauma. Extrusion of antagonistic teeth breaks down occlusion plane and loss of posterior support bring about severe wear of remained teeth. In this situation, it is needed to restore remained teeth and edentulous space by increasing vertical dimension to obtain prosthodontic rehabilitation space and to correct occlusion plane. In this case report, the patient had a masticatory problem with loss of posterior teeth support and an esthetic problem of shortened anterior teeth. Before the tooth preparation for the prosthodontic restoration, the patient used removable device for 2 months to increase vertical dimension reversibly. After that, he got provisional fixed restoration with irreversible tooth reduction and used it for 3 months. It had spent 5 month to evaluate the adaptation state on final restoration with incresed vertical dimension. The increasing amount was 3 mm, which was relatively in less degree and masticatory system adapted to the increased vertical dimension without any pathologic changes. Final restoration was made to have equal-intensity contacts on all teeth in a verifiable centric relations and immediate disclusion of all posterior contacts the moment the mandible moves in any direction from centric relation. In addition, metal occlusion surface on posterior teeth was applied to prevent excessive muscle activation, occlusal trauma and the porcelain fracture.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.2
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• pp.175-186
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• 2022

A crossed occlusion resulting from the presence of posterior teeth in one arch but no opposing teeth in the opposite arch results in collapse of the vertical dimension. In this case, the patient has a class III malocclusion with crossed occlusion and anterior crossbite. In order to evaluate the proper vertical dimension, provisional denture was used to stabilize the vertical occlusal dimension for 3 months. After, provisional fixed restoration was used for the stabilizing occlusal relationship and aesthetic improvement for lip support. Definitive prosthesis in implants in the mandible and abutments in the maxillary were using Porcelain-fused-to-metal crown (PFM) crown and the maxillary unilateral edentulous area was treated with removable partial dentures. Through this, proper support of the posterior region and normal anterior occlusal relationship were formed, and the patient was able to obtain aesthetically and functionally satisfactory treatment results.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.145-156
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• 2010

Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.423-436
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• 2011

Trauma from occlusion (TFO) is a pathologic alterations which develop in the periodontium as a result of undue masticatory force. The purpose of this article is to review the controversies about TFO. There are evidences that TFO is a risk factor in the progression of periodontitis. Tooth mobility should be reduced by selective occlusal adjustment. TFO can be developed dependent on the masticatory pattern, occlusion and anterior overbite in sound periodontal conditions. Secondary TFO may aggravate unstable occlusion. If "loss of posterior support" was occur, the problems were worsen. Extrusion, migration, rotation and pathologic deviation can be resulted. Opposite contention is the "shortened dental arch" concept. However, these two concepts persue the occlusal stability together. To treat TFO adequately, exact diagnosis and multi-disciplinary treatment should be needed.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.119-132
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• 2023

The loss of posterior occlusal support due to tooth loss is likely to lead to compensatory protrusion and labial tilt of the anterior teeth, which may be accompanied by a deep bite and a decrease in vertical dimension. The patient may suffer from a decrease in masticatory efficiency, inaccurate pronunciation, facial appearance changes, and temporomandibular joint disorder, so stable occlusal formation with support of posterior occlusion and restoration of vertical dimension is necessary. We report the case of a patient with reduction of vertical dimension, and inaccurate pronunciation due to multiple tooth loss who underwent full mouth rehabilitation with increased vertical dimension accompanied by phonetic analysis and achieved satisfactory functional and aesthetic results.

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