Occlusal Adjustment and Prosthodontic Reconstruction on the Open-bite Patient. - Intentional Decrease of Occlusal Vertical Dimension -

자연치 교합조정에 의한 전치, 구치 개교합의 보철적 수복 - 수직고경의 의도적 감소증례

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.