• Title/Summary/Keyword: Unstable mandibular position

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Using treatment denture and digital technology in patient with unstable mandibular movement: a case report (불안정한 하악위를 가진 무치악 환자에서 치료의치와 디지털 기술을 이용한 치료 증례)

  • Eunji Oh;Woohyung Jang;Chan Park;Kwidug Yun;Hyun-Pil Lim;Sangwon Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.3
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    • pp.168-175
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    • 2023
  • Long-term use of inappropriate prosthesis often results in habitual closure or irregular mandibular movements. In that case, guide to the stable centric position is difficult. Therefore, by using a treatment denture, the muscles and TMJ should be stabilized and the jaw relation should be acquired with the treatment position. Compared to the conventional method, digital technology in fabrication complete denture has the advantage of reproducing a stable tooth arrangement in cases of difficult tooth alignment, minimizing laboratory errors and reducing denture fabrication time. Therefore, in this case, the final denture was fabricated by digitally reproducing the stable treatment position, vertical dimension, and lip support with a treatment denture, and satisfactory results were obtained.

Full mouth rehabilitation in edentulous patient with unstable mandibular position using flat table treatment dentures and CAD-CAM technology (치료의치와 CAD-CAM 기술을 이용한 불안정한 하악위를 가진 완전 무치악 환자의 치료 증례)

  • Kim, Yuyeon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.330-338
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    • 2022
  • For edentulous patients with unstable mandibular movements and abnormal facial features due to condylar fractures and morphological abnormalities, it is important to find a stable mandibular position. In this case, the patient's facial improvement, mandibular movement stability, and denture stability were improved by using flat table treatment dentures. In addition, computer-aided design/manufacturing (CAD-CAM) technology was used in denture fabrication to maintain the vertical dimension and lip support of flat table treatment dentures, we report good results in improving the patient's discomfort.

Coronoidectomy for reduction of superolateral dislocation of mandible condyle

  • Seok, Hyun;Ko, Seung-O;Baek, Jin-A;Leem, Dae-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.3
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    • pp.182-187
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    • 2022
  • Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.

Full mouth rehabilitation in partially edentulous patient with an unstable mandibular position (불안정한 하악위를 가진 부분 무치악 환자에서 전악 수복 증례)

  • Donghwi Yook;Younghoo Lee;Seoung-Jin Hong;Ahran Pae;Kwantae Noh;Hyeong-Seob Kim;Kung-Rock Kwon;Janghyun Paek
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.308-315
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    • 2023
  • In the case of a patients who have lost the centric stop and have a staggered occlusion of the residual teeth, various movements occur when the denture is loaded. Implant placement is necessary to reinforce the retention, support, and stabilization elements to reduce denture movement. However, in this case, considering the patient's age, aversion to surgery, and bone loss, implants were not placed and restoration was performed with a removable partial denture. In this case, it is important to set the correct mandibular position for restoration because the patient has a habit of chewing with the remaining teeth. In this case, a stable mandibular position was established using a gothic arch tracing, and good results were obtained by restoring with partial dentures, so this is reported.

Orthognathic surgery on Skeletal Class III patiens with collapsed vertical dimension: case report (수직고경이 붕괴된 골격성 III급 부정교합자의 악교정 수술 치험례)

  • Choi, Youn-Kyung;Kim, Yong-Deok;Park, Soo-Byung;Kim, Yong-Il;Kim, Seong-Sik;Son, Woo-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.1
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    • pp.70-79
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    • 2016
  • Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

A removable partial denture treatment with the Dahl concept applied to a patient with a deep bite (과개교합 환자에서 Dahl concept을 적용한 가철성 보철 치료)

  • Kim, Chang-Hwan;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.110-120
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    • 2020
  • Although not all kinds of deep bite occlusions are considered pathological states, they can cause persistent wear and eruption of the anterior mandibular teeth if the anterior occlusal contact is unstable or accompanied by an occlusal disharmony. The patient was a 72-year-old man with no occlusal contact of the remaining anterior teeth in the centric relation position because of a skeletal class II malocclusion and loss of occlusal support. If the vertical dimension needs to be increased for prosthetic restoration in a patient with a deep bite, the amount of vertical dimension increase must be determined through precise diagnosis. This is because the overjet may increase and cause an unstable occlusion. In this review, we report the case of a patient with a stable occlusion and good treatment results achieved by using a removable partial denture prosthesis and applying the Dahl concept.

THREE DIMENSIONAL FINITE ELEMENT ANALYSIS ON THE MANDIBULAR CANTILEVERED PROSTHESIS SUPPORTED BY IMPLANTS (임프란트로 지지된 하악 켄티레버 보철물의 3차원 유한요소 분석)

  • Cho, Chul;Shin, Sang-Wan;Kwon, Jong-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.5
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    • pp.724-743
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    • 2000
  • One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

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