The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Full mouth rehabilitation with fixed prostheses by increased vertical occlusal dimension using 3D printed splint in a patient with excessive tooth wear

과도한 치아 마모 환자의 3D 프린팅 교합안정장치를 이용한 수직 교합 고경 증가를 동반한 고정성 보철물 전악 수복 증례

  • Se-Young Kim (Department of Prosthodontics, School of Dentistry, Dankook University) ;
  • Soo-Yeon Shin (Department of Prosthodontics, School of Dentistry, Dankook University)
  • 김세영 (단국대학교 치과대학 치과보철학교실) ;
  • 신수연 (단국대학교 치과대학 치과보철학교실)
  • Received : 2023.04.19
  • Accepted : 2023.07.10
  • Published : 2023.07.31
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Abstract

Severe wear of the anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. Additionally, when treating patients with collapsed occlusion due to multiple tooth loss and tooth wear, it is important to determine the presence of vertical dimension loss through accurate clinical and radiographic examinations and diagnostic wax-up. The patient of this case is a 44-year-old female patient who complained of overall tooth wear and loss of posterior teeth due to bruxism and clenching habits, visited the hospital with the address of restoring masticatory function and improving aesthetic appearance through prosthetic treatment. Through model analysis and diagnostic wax-up, an increase in vertical dimension was determined, and full mouth restoration with fixed prostheses was planned. The degree of adaptation to the vertical dimension was confirmed step by step using an occlusal splint designed with CAD (Computer aided design) software and 3-D (3-Dimensional) printed, and then restored with provisional restoration and after a 4-month adaptation period, the entire dentition was restored with metal ceramic crowns and implants. Through this procedure, satisfactory treatment results were obtained in terms of function and aesthetics.

전치부의 심한 교모는 측방운동 중 구치부를 교모로부터 보호하는 전방유도의 상실을 촉진하며, 구치부의 상실은 교합의 부조화 및 수직고경의 감소를 초래한다. 또한 다수의 치아상실과 치아 마모로 인해 교합이 붕괴된 환자 치료시에는 정확한 임상 및 방사선 검사, 진단용 왁스업을 이용하여 수직고경 상실에 대한 여부를 파악하는 것이 중요하다. 본 증례의 환자는 44세 여성환자로 이갈이와 이악물기 습관으로 전체적인 치아 마모 및 구치부 상실로 저작기능 및 발음, 심미적 불편감을 호소하였으며, 보철적 치료를 통해 저작기능 회복 및 심미적 안모 개선을 주소로 내원하였다. 과도한 치아 마모와 상, 하악 구치부의 결손으로 감소한 수직교합고경 및 전치부의 심한 수직피개를 보였다. 모형 분석과 진단납형을 통해 수직고경 증가를 결정하였으며, 고정성 보철물로 전악수복을 계획하였다. 안정된 치료위로의 적응을 위해 CAD (Computer aided design)소프트웨어로 디자인한 3D(3-Dimensional) 프린팅 교합안정장치를 이용하여 단계적으로 수직고경에 대한 적응도를 확인하였으며, 이 후 임시치아로 수복하여 4개월의 적응기간 후 전체 치열은 금속도재관 및 임플란트로 수복하여 심미적 및 기능적으로 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

Keywords

References

  1. Moslehifard E, Nikzad S, Geraminpanah F, Mahboub F. Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report. J Prosthodont 2012;21:56-64. https://doi.org/10.1111/j.1532-849X.2011.00765.x
  2. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1984;52:467-74. https://doi.org/10.1016/0022-3913(84)90326-3
  3. Willis FM. Features of the face involved in full denture prosthesis. Dent Cosmos 1935;77:851-4.
  4. Silverman MM. The speaking method in measuring vertical dimension. 1952. J Prosthet Dent 2001;85:427-31. https://doi.org/10.1067/mpr.2001.116139
  5. Rivera-Morales WC, Mohl ND. Restoration of the vertical dimension of occlusion in the severely worn dentition. Dent Clin North Am 1992;36:651-64. https://doi.org/10.1016/S0011-8532(22)01821-3
  6. Johnson A, Wildgoose DG, Wood DJ. The determination of freeway space using two different methods. J Oral Rehabil 2002;29:1010-3. https://doi.org/10.1046/j.1365-2842.2002.00950.x
  7. Gwon GR. The prosthetic approach for collapsed vertical dimension of occlusion. J Korean Acad Stomatognathic Funct Occlusion 2004;20:170-81.
  8. Park JH, Jeong CM, Jeon YC, Lim JS. A study on the occlusal plane and the vertical dimension in Korean adults with natural dentition. J Korean Acad Prosthodont 2005;43:41-51.
  9. Verrett RG. Analyzing the etiology of an extremely worn dentition. J Prosthodont 2001;10:224-33. https://doi.org/10.1111/j.1532-849X.2001.00224.x
  10. Mehta SB, Banerji S, Millar BJ, Suarez-Feito JM. Current concepts on the management of tooth wear: part 3. Active restorative care 2: the management of generalised tooth wear. Br Dent J 2012;212:121-7. https://doi.org/10.1038/sj.bdj.2012.97
  11. Sato S, Hotta TH, Pedrazzi V. Removable occlusal overlay splint in the management of tooth wear: a clinical report. J Prosthet Dent 2000;83:392-5. https://doi.org/10.1016/S0022-3913(00)70032-1
  12. Dawson PE. Functional occlusion: from TMJ to smile design. St. Louis: Mosby. Elsevier; 2007.
  13. Zanatta G, Silva WAB, Silva FA, Ramos G da G, Casselli H. Assessment of painful symptomology in patients with temporomandibular disorders by means of a combined experimental scale. Braz J Oral Sci 2016;5:1244-8.
  14. Casselli H, Landulpho AB, Silva WA, Silva FA. Electrognathographic evaluations of rehabilitated edentulous patients. Braz Oral Res 2007;21:355-61. https://doi.org/10.1590/S1806-83242007000400013
  15. Marin DO, Leite AR, de Oliveira Junior NM, Compagnoni MA, Pero AC, Arioli Filho JN. Reestablishment of occlusal vertical dimension in complete denture wearing in two stages. Case Rep Dent 2015;2015:762914.
  16. Gianelly AA, Ruben MP, Risinger R. Effect of experimentally altered occlusal vertical dimension on temporomandibular articulation. J Prosthet Dent 1970;24:629-35. https://doi.org/10.1016/0022-3913(70)90099-5
  17. Mays KA. Reestablishing occlusal vertical dimension using a diagnostic treatment prosthesis in the edentulous patient: a clinical report. J Prosthodont 2003;12:30-6. https://doi.org/10.1053/jpro.2003.7
  18. Fouda SM, Al-Attar MS, Virtanen JI, Raustia A. Effect of patient's personality on satisfaction with their present complete denture and after increasing the occlusal vertical dimension: a study of edentulous egyptian patients. Int J Dent 2014;2014:635943.
  19. Boero RP. The physiology of splint therapy: a literature review. Angle Orthod 1989;59:165-80.
  20. Kusnoto B, Schneider BJ. Control of the vertical dimension. Semin Orthod 2000;6:33-42. https://doi.org/10.1016/S1073-8746(00)80007-9
  21. Capp NJ. Occlusion and splint therapy. Br Dent J 1999;186:217-22. https://doi.org/10.1038/sj.bdj.4800069a
  22. Syme VJ, Lamb DJ, Lopattananon N, Ellis B, Jones FR. The effect of powder/liquid mixing ratio on the stiffness and impact strength of autopolymerising dental acrylic resins. Eur J Prosthodont Restor Dent 2001;9:87-91.
  23. Ligon SC, Liska R, Stampfl J, Gurr M, Mulhaupt R. Polymers for 3D printing and customized additive manufacturing. Chem Rev 2017;117:10212-90. https://doi.org/10.1021/acs.chemrev.7b00074
  24. Wesemann C, Spies BC, Sterzenbach G, Beuer F, Kohal R, Wemken G, Krugel M, Pieralli S. Polymers for conventional, subtractive, and additive manufacturing of occlusal devices differ in hardness and flexural properties but not in wear resistance. Dent Mater 2021;37:432-42. https://doi.org/10.1016/j.dental.2020.11.020
  25. Rosar JV, Barbosa TS, Dias IOV, Kobayashi FY, Costa YM, Gaviao MBD, Bonjardim LR, Castelo PM. Effect of interocclusal appliance on bite force, sleep quality, salivary cortisol levels and signs and symptoms of temporomandibular dysfunction in adults with sleep bruxism. Arch Oral Biol 2017;82:62-70. https://doi.org/10.1016/j.archoralbio.2017.05.018
  26. Domagala I, Przystupa K, Firlej M, Pieniak D, Gil L, Borucka A, Naworol I, Biedziak B, Levkiv M. Analysis of the statistical comparability of the hardness and wear of polymeric materials for orthodontic applications. Materials (Basel) 2021;14:2925.
  27. Wood GN. Centric relation and the treatment position in rehabilitating occlusions: a physiologic approach. Part II: The treatment position. J Prosthet Dent 1988;60:15-8.