• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.121-134
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• 2004

This article describes a clinical protocol for the conventional rehabilitation of patient diagnosed with partial anodontia. A combined dental therapy approach was used and included endodontic therapy and root capping on the maxillary central incisors, fabrication of a maxillary overdenture, and fabrication of mandibular konus overdenture supported by 3 konus abutments. Within this protocol, tooth-supported overdenture prostheses are used for 2 purposes: first, to obtain the most rigid retention and function at an established maxillary-mandibular relationship; and second, to continuously maintain function and esthetic appearance applying immediate dentures after teeth extraction. The idea behind this protocol and its associated clinical procedures is presented along with a discussion compared with implant therapy. In the case introduced, and after 7 years of observation, the therapy can be seen as a success. We increased the occlusal vertical height in this case, but it would be more appropriate to see this as recovering the occlusal vertical height that was lost. The process of increasing the occlusal vertical height, that is restoration of the face, modification of the extrinsic occlusion of the incisors, and retraction of the mandible is very difficult and important. Ultimately, class III malocclusion is fixed, adequate occlusal vertical height is gained, and the retracted posterior anodontial portion is restored by prosthodontic dentures based on the rigid support theory. The result of the therapy done on the later-achieved malocclusion with partial anodontia on the posterior portion must consider the following in order to maintain the safety of the esthetics of the tooth and face for a period of time: 1) occlusal restoration with an ideal occlusal vertical height, 2) allowance of the final occlusion induced by the functional relationship of the upper and lower jaw, 3)final occlusion functionally induced by the lip competence limit.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.121-129
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• 2020

From the point of view of oral rehabilitation, the treatment of extensive tooth wear requires a prosthetic approach. Physiological tooth wear is considered as a normal process and generally does not require treatment, but excessive tooth wear causes problems like inadequate occlusion and esthetics. Changes of occlusal vertical dimension should be made through accurate diagnosis and analysis. Also, the patient's adaptation to the changed occlusal vertical dimension should be assessed over time. This case was a 60-year-old male patient who complained of a decrease in chewing function and esthetics due to severe tooth wear. Full-mouth rehabilitation was performed with a tooth supported fixed prosthesis. An occlusal stabilization splint and provisional restoration were used to evaluate the adaptation to increased occlusal vertical dimension and induce a stable centric relation position. After that, monolithic zirconia prosthesis was delivered. We report this as a satisfactory functional recovery and esthetics.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.1
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• pp.64-71
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• 2024

The most critical aspect of full-arch prosthodontic treatment is evaluating whether the patient's vertical occlusal dimension is appropriate, and if necessary, restoring it through increasing vertical dimension. If the vertical occlusal dimension is too low, it can lead to reduced chewing efficiency, as well as not only aesthetic concerns but also potential issues like hyperactivity of muscles and posterior displacement of the mandible. This report is about the patient dissatisfied with pronunciation and aesthetics due to an inappropriate vertical occlusal dimension resulting from prior prosthetic interventions, underwent full-arch prosthodontic restoration treatment. Through the utilization of digital diagnostic apparatus, a comprehensive evaluation was undertaken for patient's vertical occlusal dimension, occlusal plane orientation, and the condition of prosthetic restorations. Through 3D facial scanning, the facial landmarks were discerned, and subsequently, the new occlusal plane was established. This provided the foundation for a digitally guided diagnostic wax-up. An elevation of 5 mm from the incisor was determined. Comprehensive dental rehabilitation was then executed for all remaining teeth, excluding the maxillary four incisors. The treatment protocol followed a systematic approach by initially creating implant-supported restorations on both sides of the dental arch to establish a stable occlusal contact. Subsequently, prosthetic restorations for the natural dentition were generated. Diagnostic and treatment planning were established through the utilization of facial scanning. This subsequently led to a reduction in treatment complexity and an expedited treatment timeline.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.262-272
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• 2015

Loss of molar support and abnormal jaw relationship lead to occlusal disharmony and cause pathologic signs. Full mouth rehabilitations with reestablishment of occlusal schemes are needed. In this case, the 75 year-old female patient showed posterior bite collapse, irregular occlusal plane and Class II jaw relationship. By observing her profile and interocclusal distance, she was diagnosed as loss of occlusal vertical dimension. Treatment plan is to restore maxillay class I removable partial denture and mandibular fixed prosthesis and to establish vertical dimension and harmonious occlusal plane. Occlusal vertical dimension of 19 mm, which is obtained by 7.5 mm increase between maxillary right lateral incisor and mandibular canine, was established using temporary prosthesis via diagnostic wax-up. Patient adaptation with newly formed vertical dimension was verified during 8 week follow-up period. Within the information of interim prostheses, final restoration was constructed and delivered. The patient showed sound occlusal scheme and esthetic profile.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.1
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• pp.31-39
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• 2018

The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.1
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• pp.42-47
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• 2014

Decrease of occlusal vertical dimension (OVD) due to loss of teeth structure and destruction of the occlusal plane by severely worn dentition may cause cross bite or temporomandibular joint disorder by following change of facial feature or the loss of anterior guidance. Full mouth rehabilitation via an increase of the OVD can be considered to avoid this problem and proper evaluation of patient's OVD is essential. An 80 year old male visited for overall prosthodontic treatment, cross bite due to continuous wear and following decrease of the OVD were observed. We analyzed the existing occlusal relationship using the diagnostic cast, the radiographic evaluation and clinical test, and then proper increase of OVD was selected. The new OVD on diagnostic wax up was placed by the temporary restoration. After 3 months of observation period, final restoration with fixed partial dentures and implant overdenture were made. Throughout the follow-up period of 8 months, the aesthetic and functional improvement can be obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.305-310
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• 2012

It is a great challenge for dentists to do prosthetic restorations of a patient with reduced occlusal vertical dimension (OVD). Proper determination of the OVD is significant. An 85-year-old male patient came in with missing right maxillary posterior teeth. After diagnostic wax-up, reversible provisional prostheses were used to evaluate the new OVD in the maxilla and mandible. After that, the patient was evaluated clinically based on the criteria of esthetic, phonetic, and OVD. After 8 weeks, teeth with excessive wear were treated with root canal therapy and fiber post and core and irreversible provisional prostheses were done. After 8 weeks of observation period, final restorations with fixed partial dentures and removable partial dentures were made. Throughout the follow-up period of 6 months, no symptoms related with increased OVD and mechanical complications were observed.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.110-120
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• 2020

Although not all kinds of deep bite occlusions are considered pathological states, they can cause persistent wear and eruption of the anterior mandibular teeth if the anterior occlusal contact is unstable or accompanied by an occlusal disharmony. The patient was a 72-year-old man with no occlusal contact of the remaining anterior teeth in the centric relation position because of a skeletal class II malocclusion and loss of occlusal support. If the vertical dimension needs to be increased for prosthetic restoration in a patient with a deep bite, the amount of vertical dimension increase must be determined through precise diagnosis. This is because the overjet may increase and cause an unstable occlusion. In this review, we report the case of a patient with a stable occlusion and good treatment results achieved by using a removable partial denture prosthesis and applying the Dahl concept.

• 대한치과보철학회:학술대회논문집
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• 2000.04a
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• pp.40-40
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• 2000

• Journal of the Korean Academy of Esthetic Dentistry
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• v.32 no.1
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• pp.23-32
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• 2023

A patient with para-functional habits can cause widespread teeth wear, along with temporomandibular joint disorders and myofascial pain syndrome in the masticatory muscles. Prolonged teeth wear is associated with a decrease in vertical occlusal dimension, leading to issues such as changes in facial morphology, decreased masticatory efficiency, and temporomandibular joint disorders. To achieve a three-dimensional full-mouth rehabilitation in patients with decreased vertical occlusal dimension, accurate diagnosis, analysis, and proactive treatment planning are essential. Prosthetic treatment accompanied by the restoration of physiological vertical occlusal dimension and the re-establishment of a normal occlusal plane is necessary. This case report presents a full-mouth rehabilitation case involving a patient with overall teeth wear, showing decreased vertical occlusal dimension which results in discomfort in the temporomandibular joint and aesthetic dissatisfaction. The report highlights the successful outcome achieved through the use of occlusal stabilization splint for temporomandibular joint stability and Gothic arch tracing devices for the re-establishment of intermaxillary relationships. Also, through adjustments and adaptation assessment using provisional prostheses, favorable outcomes were achieved both functionally and aesthetically.