• The Journal of Korean Academy of Prosthodontics
• /
• v.50 no.4
• /
• pp.311-317
• /
• 2012

When wearing complete dentures, patients want to function naturally within a physiologically stable range. To do this, recovery of esthetics, biologically stable arrangement and contour, and occlusal contacts with denture stability are necessary. In this case report, a complete denture patient of adverse conditions was presented. To increase stability of the dentures, functional impression was made by border molding using the neutral zone. The dentures were checked for physiological centric relations and stable occlusion. The clinical results showed satisfactory results on function and esthetics.

• The korean journal of orthodontics
• /
• v.6 no.1
• /
• pp.55-63
• /
• 1976

This study was undertaken to establish the roentgenocephalometric standards of the Korean children in Hellman dental age III C. The subjects consisted of 33 males and 33 females with the normal occlusion and acceptable profile. The lateral cephalometric films were taken with the teeth in centric occlusion, the soft tissue outline of the nose, lips, and chin was made visible by the low-speed films, 70Kvp, 100Mas. Their linear and angular measurements were performed by Jarabak's methods. The following results were obtained; 1) The author made the tables of standard deviation from the measured values. 2) Each linear measurement of the skull was greater in males than in females. 3) The maxillary basal bones were more protrusive in Korean children than in Caucasian. 4) The degree of the facial convexity was larger in Korean children than in Caucasian. 5) The labial inclination of the upper & lower incisors was greater in Korean children than in Caucasian. The labial inclination of the upper incisor was greater in females, but the labial inclination of the lower incisor was greater in males.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.1
• /
• pp.35-41
• /
• 2020

Patients with collapsed occlusal support and unilateral chewing show parafunctional mandibular movements, which can be complicated in older patients. Gothic arch tracing and split cast technique are used to confirm the deviation between centric relation and anterior habitual bite in patient who has oral dyskinesia and collapsed occlusion. Temporary denture as occlusal stabilization appliance was provided for stable occlusion and reproducible mandibular movement. Definitive denture was fabricated by lingualized occlusion concept.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.16 no.2
• /
• pp.133-147
• /
• 2000

A well-planned, precise occlusal adjustment of natural teeth has some distinct advantages over other forms of occlusal therapy. It should be emphasized, however, that an occlusal adjustment is an irreversible procedure and has definite contraindications in some mouths. Generally, the treatment methods for the patients that has open-bite will be following as below. : (1) Use of removable orthopedic repositioning appliance, (2) Orthodontics, (3) Full or partial reconstruction of the dentition, (4) Orthognathic surgical procedure, (5) Occlusal adjustment of the existing natural teeth, (6) Any combination of the above. Above all, the advantages of occlusal adjustment of natural teeth are : (1) the patient is more able to adapt to the changes in jaw position and posture; (2) the phonetic or speaking ability of the patient is not significantly changed and usually is improved; (3) the esthetics of the natural teeth is not altered and often is better; (4) the hygiene of the individual teeth is easily maintained; and (5) the functional usage of the teeth as cutting and chewing devices is markedly improved. The objective of an occlusal adjustment, as with any form of occlusal therapy, is to correct or remove the occlusal interferences, or premature contacts, on the occluding parts of the teeth which prevent a centric relation closure of the mandible. A systematic, disciplined approach can be followed in treatment, the objectives should be listed. They are : (1) Centric relation occlusion of the posterior teeth. (2) Proper "coupling" of the anterior teeth. (3) An acceptable disclusive angle of the anterior teeth in harmony with the condylar movement patterns. (4) Stability of the corrected occlusion. (5) Resolution of the related symptoms. For the patient with open-bite on anterior and posterior teeth, this case report shows the treatment methods in combination the fixed prosthesis with the selective cutting of the natural teeth. Occlusal adjustment is no longer an elective procedure but a mandatory one for patients requiring restorations and those in treatment for TMD dysfunctions or those whose dentitions show signs of occlusal trauma. Occlusal adjustment is essential for all who do not display the above lists.

• Journal of Oral Medicine and Pain
• /
• v.20 no.1
• /
• pp.185-194
• /
• 1995

The purpose of this study was to estimate primary diagnosis, prediction of prognosis and recognition fo treatment progress for treatment of TMD patients through measuring the various ranges of mandibular movement in normal and TMDs patients using Mandibular Kinesiograph K-6 Diagnostic system. In normal groups, 20 adults were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. In Patients group, we selected 31 outpatients who were confirmed to TMDs with clinical examination and radiographic findings. The obtained results were as follows : 1. In maximal opening, patient group was showed the limitation of vertical movement range (P<0.01) and lager lateral deviation than in normal group (P<0.05). And actual dimensional displacement of opening was calculated larger in normal group (P<0.05). 2. In protrusive movement, patients group was showed the limitation of anteroposterior movement range (P<0.001) and larger deviation than in normal group (P<0.01). And actual 3 dimensional displacement of protrusion was calculated larger in normal group (P<0.001). 3. In lateral maximum excursion, compared with normal group patient group was no significant differences to affected side, but was showed the limitation of lateral movement to unaffected side (P<0.001). 4. There was no significant difference in movement velocity of opening and closing in both groups. 5. Mandibular movement from physiologic rest position to centric occlusion was moved more anteroposteriorly in patient group. 6. Mandibular movement from centric relation to centric occlusion was no significant difference in both groups.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.17 no.4
• /
• pp.275-282
• /
• 2001

Centric relation is defined the horizontal position between maxilla and mandible when condylar head of mandible is positioned adequately in mandibular fossa. The most recent concept of centric relation position is defined as the mandibular position in which the condyles are in their most superoanterior position in the articular fossa, resting against the posterior slope of the articular eminences, with the articular disk properly interposed. To be suitable as a reference point during occlusal management, a mandibular position of centric relation has to be functionally acceptable to the patient and clinically reproducible and achievable during everyday practice. There are numerous methods for determination of centric relation, and in this study we used three of them, Gothic arch tracing(Group I), leaf gauge(Group II), and anterior jig(Group III). The subjects were 10, 8 men and 2 women, age-ranged from 23 to 26 years old, had no prosthetics in thier mouth, and had no sign and symptom of temporomandibular disorders. We gained three occlusal records using each method, and then the degree of the reproducibility was examined with split cast technique. In this study the reproducibility of centric relation using split cast technique was greater in the order of Group I(mean 1.6), Group II(mean 1.4), and Group III(mean 1.3), but there was no significant differences among them statistically(p>0.05).

• The Journal of Korean Academy of Prosthodontics
• /
• v.31 no.3
• /
• pp.351-384
• /
• 1993

Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.467-474
• /
• 2019

Recently, many patients undergo anterior prosthetic treatment for esthetic reasons. In some patients complain about functional reasons such as inaccurate pronunciation and occlusal discomfort after the treatment. Anterior teeth are important esthetically but in the occlusal point of view, anterior guidance is the second most important factor in occlusion, next to centric relation. Failure to determine an appropriate anterior guidance might lead to posterior occlusal interference, which can highly affect the stability of the posterior teeth. Also, discomfort might occur if the customized interior guidance is not in harmony with the patient's envelope of function. The patient in this case complained of overall discomfort in the maxillary anterior area after prosthetic treatment. The expressed difficulty in pronunciation, unstable occlusion due to lack of stable holding contact and discomfort of the facial muscles. Maxillary anterior prostheses were refabricated through systematic diagnosis and treatment and thus, this case presents esthetical and functional satisfaction to both the patient and the dentist.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.4
• /
• pp.477-482
• /
• 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
• /
• v.16 no.3
• /
• pp.171-185
• /
• 2000

The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.