• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.65-71
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• 2016

Gradual occlusal attrition is a normal process of aging. However, severe attrition causes pathogenic pulp, occlusal disharmony, functional disorder and esthetic problems. Alteration of vertical dimension should be considered for space regaining for tooth restoration, esthetic improvement or correction of occlusal relationship. Vertical dimension should be determined within the range of minimal invasive process satisfying patient's esthetic requirements and operator's functional goal. And patient's adaptation to newly determined vertical dimension should be assessed simultaneously. Deep overbite is not a simple problem of overbite, instead it is an usually complicated problem with anterior-posterior occlusal relationship. Considering these facts, appropriate restoration of edentulous part as well as improvement of anterior-posterior relationship should be performed to solve this fundamental problems. In this study, a 67 year-old male patient with many worn teeth and loss of posterior teeth was treated with removable partial denture at edentulous mandibular area to increase vertical dimension and fixed prostheses at dentulous maxillary and mandibular area. With these treatments, we attained a satisfactory result in functional and esthetic aspects as a report case.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.160-166
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• 2016

Although physiologic abrasion in normal range need not to be corrected, when hard tissue of teeth are worn abnormally fast, it can cause severe damage and destroy esthetics and, functional structure of occlusion consequently. To establish a correct occlusal plane and space for the patient with worn dentition, it is necessary to increase vertical dimension. However, actual occlusal vertical dimension remains unhanged with compensation for the increase of alveolar bone height equivalent to the decrease of teeth length. A 74-year-old male presented with worn dentition and fractured tooth. Based on the assessment of OVD including clinical findings, full-mouth rehabilitation without increase of OVD was planned. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition without changing occlusal vertical dimension.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.347-353
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• 2018

Gradual attrition is a normal process of aging, but severe attrition causes occlusal disharmony, functional disorder and esthetic problems. The collapse of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). And it induces the pathologic change of the TMJ, unaesthetic facial appearance and decreased masticatory function. In this case, 70 year-old male presented with decreased vertical dimension and esthetic problems due to worn dentition. Based on assessment of intraoral findings, diagnostic cast and radiographic examination, full-mouth rehabilitation with increase of OVD was planned. After 10 month follow-up, occlusal stability is maintained and through this procedure, satisfactory outcomes were achieved in esthetic and functional aspects.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.477-482
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• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.33-43
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• 2023

Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.320-329
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• 2022

Physiological wear of occlusal surface is inevitable throughout the lifetime, and considered to be normal. Pathologic wear, however, may cause fatal damage to the occlusal surface and destroy esthetics and proper anterior guidance. In such cases, rehabilitation of occlusal wear should be followed by thorough evaluation and diagnosis. In this present case, severe occlusal wear was found in the labial surfaces of mandibular anterior teeth and palatal surfaces of maxillary anterior teeth. Occlusal vertical dimension was evaluated and decided to be regained due to insufficient amount of restorative space. After determining new occlusal vertical dimension, diagnostic wax-up is usually performed to continue prosthodontic treatment. In this case with collapsed occlusion and loss of occlusal vertical dimension, conventional diagnostic wax-up was replaced with various digital devices. Diagnostic wax-up was digitally performed in the software and provisional prosthesis was fabricated with digital tools. With verification with provisional prosthesis, the entire dentition was rehabilitated with newly set occlusal vertical dimension and proper anterior guidance.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.234-244
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• 2023

Tooth wear refers to the loss of dental hard tissue caused by various physiological and pathological causes, and excessive pathological wear can cause complications such as pathological changes in dimensions, occlusal disharmony, loss of function, and aesthetic problems. The cause of tooth wear can be caused by attrition, abrasion, corrosion and abfraction, and it is known to act in a multifactorial etiology in interocclusal activity. In patients with excessive pathological wear, it is important to determine whether or not the vertical dimension of occlusion is reduced, and complete oral rehabilitation should be achieved with the adaptation of the neuromuscular and temporomandibular joint through accurate diagnosis and analysis. The patient in this case was a 63-year-old male patient, who presented discomfort to cold beverage due to severe tooth wear. After analysis of the patient's vertical dimension of occlusion, a full mouth rehabilitation was performed with increasing vertical dimension of occlusion. The goal of treatment was to improve the occlusal plane with the equal-intensity contact of all teeth, harmonious anterior guidance and immediate disclusion of all posterior contacts. After rehabilitation, the patient was satisfied with function and esthetic appearance.

• 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.53 no.1
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• pp.26-38
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• 2015

Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.205-211
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• 2017

Loss of posterior support may cause extrusion of antagonistic teeth and excessive wear of remaining teeth which often leads to the destruction of the occlusal plane. In such cases, it is critical to verify the need to increase vertical dimension of occlusion (VDO). Should you increase VDO, provisionalization is crucial in evaluating function and esthetics. Double scanning technique is a useful method when fabricating definitive restoration that mimic provisional restoration. In this case, a patient with apparently no loss of VDO and insufficient interocclusal space for dental materials due to loss of posterior support and extrusion of antagonistic teeth was rehabilitated using double scanning technique.