• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.87-108
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• 1996

This study was intended to perform cephalometric analysis of the facial soft tissue profile after surgical correction of skeletal Class III malocclusion after SSRO in 29 patients (Males 12, females 17). Lateral cephalograms were taken in centric occlusion before and immediate, long term after surgeries. 1. Counter-clockwise rotation of mandible was observed after the surgery, average relapses of mandibular set back were 1.23-1.28mm. The net effects of the mandibular set-back after surgeries were 81.7-82.2%. Because these relapse tendencies may reduce the effects of the surgical outcomes, surgeon must consider these net before the surgical treatment planning. 2. The ratio of horizontal changes of hard tissue to soft tissue at lower lip, mentolabial sulcus, pogonion were 72.7-93.7%, 100.3%, 99.1-102.1% respectively. There were little changes at upper lip position anteroposteriorly. 3. The relationship of upper and lower lips were improved after surgery. Lower lip was posteriorly repostioned and upper lip was flattend and elongated in conjunction with deepening of inferior lobial sulcus. But profile of chin was still prominent after surgery. 4. Hard tissue horizontal changes and tissue vertical changes were significantly correlated with each other and there were reverse correlations with hard tissue vertical changes and soft tissue horizontal changes.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.405-415
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• 2019

Excessive tooth wear can cause irreversible damage to the occlusal surface and can alter the anterior occlusal relationship by destroying the structure of the anterior teeth needed for esthetics and proper anterior guidance. The anterior deep bite is not a morbid occlusion by itself, but it may cause problems such as soft tissue trauma, opposing tooth eruption, tooth wear, and occlusal trauma if there are no stable occlusal contacts between the lower incisal edge against its upper lingual surface. The most important goal of treatment is to form stable occlusal contact in centric relation. In this case report, patients with decrease in vertical dimension and anterior deep bite due to maxillary posterior tooth loss and excessive tooth wear were treated full mouth rehabilitation with increased vertical dimension to regain the space for restoration and improve anterior occlusal relationship and esthetics. The functional and aesthetic problems of the patient could be solved by the equal intensity contact of all the teeth in centic relation (CR), anterior guidance in harmony with the functional movement, and restoration of the wear surface beyond the enamel range.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.238-247
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• 2021

Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.382-388
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• 2019

Increased anterior teeth mastication following posterior teeth loss leads to greater anterior occlusal force. It may cause greater attrition of anterior teeth, traumatic force occlusion (TFO), also often followed by antagonist extrusion and occlusal disharmony. This clinical report describes the treatment for a 67-year-old female patient diagnosed with loss of both maxillary and left mandibular posterior teeth, severe attrition of maxillary and mandibular anterior teeth and extrusion of multiple teeth. A diagnostic cast was mounted on articular in centric relation (CR) position to evaluate vertical dimension (VD) and interspace. To provide adequate space for the prosthetic reconstructions, VD was increased by 3 mm on the anterior pin. And then diagnostic wax-up was completed upon that VD. Wax-up was converted to provisional restorations and verified in the patient's mouth and the final restorations were delivered. Clinical follow up examination held 3 months after temporary restoration owing to changes in vertical dimension revealed proper function in mastication without evidence of temporo-mandibular joint (TMJ) disorders. This clinical report presents successfully restoring severe attrition case with increasing vertical dimension resulting in satisfaction in esthetics and function.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.374-381
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• 2022

This case report introduces a 74-year-old male patient who visited retention deficiency of the mandibular implant overdenture, which was fabricated 20 years ago. When the existing dentures were used, the vertical dimension was reduced, the maxillary complete denture lacked lip support and retention, and the mandibular overdenture lacked clip retention due to damage to the bar attachment. After removing the damaged bar attachment, it was replaced with a ball attachment, and impressions were taken using the DENTCA^TM Tray and then the vertical dimension was measured. The gothic arch tracing was performed to record the centric relation. Obtained impressions were scanned and the shape of final dentures was designed using software and try-in dentures were fabricated using 3D printer. After evaluating the occlusal plane, occlusal relationship, facial shape, and pronunciation using the try-in dentures, the bite registration was recorded, and the final denture was manufactured based on this. The inner surface of the denture was adjusted and bilateral balanced occlusion was formed, and the housing was connected to the mandibular denture by a direct method. This case reports have shown satisfactory resultin recovering improved retention and esthetic outcome by increasing the vertical dimension and the lip support using CAD-CAM technique and the ball attachment.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.275-283
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• 2023

The progressive wear of teeth is a physiologic process of aging, but excessive wear can lead to occlusal disharmony, tooth sensitivity and pulp exposure, decreased masticatory efficiency, and aesthetic problems. It should be treated by evaluating the cause of tooth wear and establishing a stable centric relation with appropriate vertical dimension of occlusion and occlusal plane. The present case report successfully rehabilitated a full-mouth case of a severely worn dentition with the use of digital facebow transfer and virtual articulator.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.166-179
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• 2008

Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture sup-ported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior posi-tion, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly $30{\sim}35%$ higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were $160{\sim}170%$ higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively $20{\sim}25%$ higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically accept-able design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.570-593
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• 1996

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.