• Title/Summary/Keyword: 교합안정장치

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Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report (악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례)

  • Sang-Myeong Tak;Chang-Mo Jeong;Jung-Bo Huh;So-Hyoun Lee;Mi-Jung Yun
    • 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.

Full mouth rehabilitation of the patient with severely worn dentition and limited vertical dimension (심한 치아 마모와 수복공간 부족을 보이는 환자에서의 완전 구강회복 증례)

  • Yang, Min-Seong;Kim, Seong-Kyun;Heo, Seong-Joo;Koak, Jai-Young;Park, Ji-Man;Yi, Yu-Seung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.91-99
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    • 2022
  • Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient's adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

THE RETROSPECTIVE STUDY ON THE INDICATION OF THE CHIN CAP THERAPY (이모장치의 적응증에 관한 후향적 고촬)

  • Yang, Won-Sik;Kim, Byoung-Ho
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.1-12
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    • 1995
  • The purpose of this study was to predict the respose to the chincap therapy from the initial cephalometric measurements and to obtain the indication of chincap therapy. 40 patients selected for this study were classified into two groups by the occlusal stability after completion of permanent dentition and the improvement of facial profile, after chincap therapy. One was good response group which consisted of 25 children and the other was poor response group with 15 patients. Various measurements of the craniofacial structure in the initial lateral cephalogram were calculated and analyzed by t-test and discriminant analysis. The results were as follows: 1. Good response group had more horizontal growth pattern in initial stage of treatment, and the contributing measurements were $Bj\ddot{o}rk$ sum anterior-posterior facial height ratio, genial angle, lower genial angle and occlusal plane to AB plane angle. 2. The critical points and predictive values of the influential skeletal measurements were calculated. 3. The discriminant function was obtained from three major influential measurements; $Bj\ddot{o}rk$ sum, genial angle and occlusal plane to hn plane angle, and this function could discreminate correctly in $85\%$ of this samples.

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Implant supported removable dental prosthesis with magnetic attachment in crossed occlusion: A case report (엇갈린 교합에서 implant와 magnetic attachment를 이용한 국소의치 증례)

  • Lee, Yu Jin;Lee, Richard sungbok;Lee, Suk Won;Park, Su Jung;Ahn, Su Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.53-60
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    • 2017
  • When attempting to restore the oral function of a partially edentulous patient, there are a number of prosthetic treatment options available, depending on the structure of remaining teeth. For example, when only one set of maxillary and mandibular teeth are diagonally in place across from each other, it is difficult to gain stable occlusion. In this case, implants can be put in place at the corresponding edentulous area to achieve balance. By doing so, a stable occlusion can be achieved. For this case report, a patient with crossed occlusion after extraction was treated with maxillary RDP (removable dental prosthesis) and mandibular implant-supported RDP (removable dental prosthesis). Moreover, an implant fixture was placed under the posterior molar of the distal extension base diagonally across from the remaining maxillary teeth. Then, magnetic attachment was implemented. According to the patient who received the treatment, the result was functionally and aesthetically satisfactory.

Effects of Centric Relation Splint Therapy on the Occlusal Contact State in Craniomandibular Disorders (교합안정장치 치료가 교합접촉상태에 끼치는 효과)

  • Whan-Cheol Kim;Kyung-Soo Han;Seok-Man Kang
    • Journal of Oral Medicine and Pain
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    • v.18 no.2
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    • pp.71-79
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    • 1993
  • Many types of occlusal splints are used for treatment of craniomandibular disorders. Most widely used splint among them is flat-type centric relation splint. Insertion of splint into the mouth may cause increasing of vertical dimension, masticatory muscle realignment and rearrangement of maxillo-mandibular relationship, so as a result of splint treatment, occlusal relation may vary whether you like it or not. From this point of view, occlusal state of patient shold be frequently monitored to prevent undesired or harmful effect during occlusal splint therapy. The purpose of this study was to investigate the effect of occlusal splint, especially centric relation splint, on the occlusal contact state after 3 months treatment. 32 patients with craniomandibular disorders who had unilateral symptoms participated in this study. To observe and record occlusal contact state, the author used T-Scan system (Tekscan Co. U.S.A.) at both pretreatment and posttreatment. The recorded date were analyzed with regard to contact number, contact force and contact time, change of anterior tooth contact and coincidence of first contact point with affected side were observed, too. Aan last, the subjects were divided into 2 groups and compared, according to average value of VAS index, with respect to joint pain, sound and limitation of movement, respectively. The collected date were statistically processed with SPSS and the result as follows : 1. Total occlusal contact number and force were not changed by occlusal splint therapy but total occlusal contact time decreased slightly. 2. There was a tendency of increasing number of subjects with anterior tooth contact after treatment and change of first contact point side were observed in as many as 40.6% of subjects. 3. There were no difference between higher and lower group of VAS index, and between pretreatment and posttreatment in each group, either.

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Oral rehabilitation of a patient with severely worn dentition using monolithic zirconia (단일구조 지르코니아 보철물을 이용한 심한 마모 환자의 전악 수복 증례)

  • Park, Jun-Seo;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.273-279
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    • 2016
  • Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

THE EFFECT OF OCCLUSAL SPLINT THERAPY ON CONDYLAR POSITIONAL CHANGES IN MALOCCLUSION PATIENTS (부정교합환자에서 교합안정장치의 사용이 하악과두의 위치변화에 미치는 영향에 관한 연구)

  • Kim, Yung-Bok
    • The korean journal of orthodontics
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    • v.21 no.2 s.34
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    • pp.325-340
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    • 1991
  • There are evidences that occlusal splint therapy is critical to diagnose hidden akeleto-occlusal disharmonies in malocclusion patients and capable of enhancing stability after orthodontic treatment. In addition, evidences have implicated occlusal splint therapy in condylar positional changes during TMJ disorder treatment. In view of these evidences, this study was performed to investigate the effect of occlusal splint therapy on condylar positional changes in malocclusion patients and the possible clinical application of the occlusal splint as an additional orthodontic tool. For this study, 8 Angle's Class I malocclusion patients, who had centric occlusion-centric relation discrepancy within 1.0 mm and had no clinical symptoms of TMJ disorder, were selected as control group. And 22 malocclusion patients who had centric occlusion-centric relation discrepancy over 1.0 mm were selected and subdivided as Class I Malocclusion group, Class II div. 1 malocclusion group, Class II div. 2 malocclusion group, Open bite group, and Mandibular asymmetry group. For each subject the occlusal splint with mutually protected type of occlusal scheme was applied for 3 months. Condylar positions in centric relation and centric occlusion were measured using Panadent articulators and Panadent condylar position indicator (CPI) before and after occlusal splint therapy. On the basis of this study, the following conclusions might be drawn: 1, In control group, Class II div. 2 malocclusion group, and mandibular assymetry group, there were no significant differences in condylar positions before and after occlusal splint therapy. 2. In Class I malocclusion group, condyles were moved $0.27{\pm}0.45mm$ forward (p < 0.05) and $0.98{\pm}0.25mm$ upward (p < 0.01) after occlusal splint therapy. 3. In Class I malocclusion group, condyles were moved $0.24{\pm}0.21mm$ backward (p < 0.05) and $1.01{\pm}0.33mm$ upward (p < 0.01) after occlusal splint therapy. 4. In open bite group, condyles were moved $1.24{\pm}0.30mm$ upward (p < 0.01) after occlusal splint therapy. 5. In both control and experimental groups, there were no significant differences in lateral condylar positions before and after occlusal splint therapy.

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A Case Report of Maxillary Complete Edentulous Patient with a Class III Jaw Relations (III급 악골 관계를 가진 상악 편악 무치악 환자의 수복)

  • Park, Mi-hee;Hong, Jun-won;Choi, Jee-ha;Lee, Jung-jun;Park, Ju-mi;Song, Kwang-yeob;Ahn, Seung-geun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.431-436
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    • 2009
  • In a case of class III skeletal patients with severe alveolar bone resorption, it must be a complete denture treatment plan provided stable and durable occlusion. Despite a markedly increased tooth mobility and unfavorable crown-to-root ration due to periodontal tissue breakdown, if the inflammatory process is controlled and an adequate oral hygiene performed, fixed splints will be considered. Patient's discomfort will be eliminated by achievement better clinical tooth mobility using fixed splints. So it can be a cost and time effective treatment option. In this case, it used a T-Scan System for confirmation a bilateral balanced occlusion and a occlusal force distribution reflected a patient's functional mandibular movement.

Case Report : Temporomandibular Joint Involvement in Rheumatoid Arthritis (증례보고: 류마티스 관절염 환자에서 측두하악관절의 이환)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.231-236
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    • 2006
  • Rheumatoid arthritis(RA) is an of autoimmune inflammatory systemic disease. It is characterized by uncontrolled proliferation of synovial tissue and a wide array multisystem comorbidities. The disease may involve any joint of the body, but often statrs in the peripheral joints. It was reported that more than 50% of RA patients exhibit clinical involvement of TMJ. This report is a case report of dental management and progression for 16 months in patients who had severe bony change in TMJ involved rheumatoid arthritis Dental management was included palliative treatment such as interocclusal splints, physical therapy, mouth opening exercise. Although it was progressed rapidly osteolytic bone change during follow-up, no more advanced occulsal change and improved symptom and jaw motion. Further investigations about rule of dentistry in TMJ involvement in RA maybe needed.

Prosthetic rehabilitation using an obturator in a fully edentulous patient who had partial maxillectomy (상악골 부분 절제술을 받은 무치악 환자에서의 구강폐쇄장치 수복)

  • Chung, Yoo-Jin;Kim, Jong-Jin;Baik, Jin;Cha, Hyun-Suk;Lee, Joo-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.331-337
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    • 2018
  • Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.