• Title/Summary/Keyword: 불안정한 교합접촉

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Rehabilitation of unstable occlusion caused by inter-dental arch discrepancy (치열궁 부조화로 인한 불안정한 교합을 보이는 환자의 수복 증례)

  • Won, Sun;An, Kiyong;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.4
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    • pp.377-391
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    • 2015
  • Inter-dental arch discrepancy between maxilla and mandible could cause three dimensional occlusal problems, and collapse of occlusal plane, multiple teeth loss and decrease of masticatory efficiency could be observed in patient having unstable occlusal contact. Patient showing posterior bite collapse, unstable occlusal contact and improper anterior guidance should be treated to recover stable centric occlusion, occlusal contact, and anterior guidance in conjunction between prosthodontics and orthodontic treatment. This clinical report describes the favorable results of orthodontic and prosthodontics rehabilitation of patient with above mentioned problems.

Full mouth rehabilitation in patient with deep bite, inter-dental arch discrepancy and loss of vertical dimension: a case report (과개교합과 치열궁부조화 및 수직고경 감소를 가진 환자의 전악수복증례)

  • Song, Han-Sol;Lee, Ye-Jin;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-La;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.3
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    • pp.157-170
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    • 2021
  • Loss of posterior bite support might cause unstable occlusal relationship and when the mandible slides forward in the centric or habitual occlusion, excessive load is applied to the anterior region followed by causing the occlusal plane to collapse or leading to a decrease in occlusal vertical dimension. In addition, disorder of temporomandibular joint function may occur. The inter-dental arch discrepancy causes a mismatch in the vertical and horizontal overlap of the anterior and posterior regions. The deep bite in the anterior region and the scissor bite in the posterior region cause unstable occlusal contact and insufficient occlusal contact area. This report was to rehabilitate a patient with above-mentioned complex problems. Physiologic adaptation to increased vertical dimension and new occlusal plane were evaluated using provisional prostheses, and definitive prostheses was fabricated using cross-mounting technique. Stable occlusion, harmonious teeth overlap and adequate occlusal plane were established, so functionally and aesthetically satisfactory results are obtained.

Fabrication of functionally customized fixed prosthesis in a hemimandibulectomy patient with fibular graft using double scan technique: A case report (비골이식을 받은 하악골절제술 환자에서 스캔중첩법을 이용한 기능적 고정성 보철물 제작: 증례 보고)

  • Win, Thaw Thaw;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.195-201
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    • 2022
  • Hemimandibulectomy and free fibular flap (FFF) in patients with squamous cell carcinoma could disturb the functional movement of the mandible. The muscular function in the sectioned side was compromised because of the incompetency of the muscle attachment to the mandible, leading to the unstable occlusal contact in the centric and eccentric occlusion. In this report, we present a case of a 63-year-old male who underwent cancer surgery and reconstruction with fibular graft, and he needed a fixed dental prosthesis to restore tooth loss in the anterior region. Occlusal contact change and instability were found according to the bite force in the centric relation and eccentric movement. This case report aimed to present the prosthetic procedure for fabricating the functionally optimized fixed prosthesis wherein the functionally generated path (FGP) technique and digital imaging method were applied to replicate mandibular movement and vertical dimension of the patient.

Maxillary anterior prosthetic treatment concerning anterior guidance of a patient who lost stable holding contact (안정적인 교합접촉을 잃은 환자에서의 전방유도를 고려한 치료증례)

  • Park, Jong-Hoon;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.467-474
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    • 2019
  • Recently, many patients undergo anterior prosthetic treatment for esthetic reasons. In some patients complain about functional reasons such as inaccurate pronunciation and occlusal discomfort after the treatment. Anterior teeth are important esthetically but in the occlusal point of view, anterior guidance is the second most important factor in occlusion, next to centric relation. Failure to determine an appropriate anterior guidance might lead to posterior occlusal interference, which can highly affect the stability of the posterior teeth. Also, discomfort might occur if the customized interior guidance is not in harmony with the patient's envelope of function. The patient in this case complained of overall discomfort in the maxillary anterior area after prosthetic treatment. The expressed difficulty in pronunciation, unstable occlusion due to lack of stable holding contact and discomfort of the facial muscles. Maxillary anterior prostheses were refabricated through systematic diagnosis and treatment and thus, this case presents esthetical and functional satisfaction to both the patient and the dentist.

A removable partial denture treatment with the Dahl concept applied to a patient with a deep bite (과개교합 환자에서 Dahl concept을 적용한 가철성 보철 치료)

  • Kim, Chang-Hwan;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • 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.

Prosthetic treatment with correcting edentulous maxillomandibular relation (무치악치조제의 개선을 통한 보철치료)

  • Rhee, Ye-Kyu;Huh, Yoon-Hyuck;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.339-349
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    • 2014
  • If the maxillomandibular relationship is unstable or requires treatment for improved function and esthetics, the first treatment objective is to provide stable occlusal contacts. The patient has moderate mental retardation. Due to inadequate vertical overjet, horizontal arch malrelation and excessive tooth loss, full mouth rehabilitation was required. The purpose of treatment planning is to establish physiologic maxillomandibular relation. Using cephalometrics for occlusal analysis is an aid to make a decision. The amount of horizontal bone reduction was calculated with evaluating soft tissue profile. After provisional denture placement, healing of the surgical site and newly adapted arch relationship was evaluated. The patient satisfied with esthetics and showed stable holding contacts. Periodic examination is needed to exclude occlusal disharmony.

Treatment of ankylosed posterior teeth: Subluxation and Extrusion Method (골유착 대구치의 교정적 치험례)

  • Mun, Cheol-Hyeon
    • The Journal of the Korean dental association
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    • v.38 no.10 s.377
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    • pp.962-968
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    • 2000
  • 치조골과 백악질이 치근막에 의하여 경계되어지지 않고 직접 접촉된 상태인 골유착치는 치조골성장장애, 불안전 맹출, 대합치의 정출, 인접치와의 불안정한 관계 등 다양한 문제를 야기한다. 골유착치의 진단은 방사선 사진에서 치근막의 소실, 타진시의 독특한 소리, periotest를 이용한 동요도 검사 등 다양한 방법이 사용되나 그 신뢰성은 높지 않은 편이다. 따라서 저자는 통산적인 방법은 견인을 시행한 후 견인여부를 평가하여 골유착 여부를 판단하는 임상적 진단법을 사용하고 있다. 골유착치의 치료는 subluxation & extrusion법, autotransplantation법, corticotomy법, segmental osteotomy법, ostectomy법등 다양한 방법이 제시되고 있다. Subluxation & extrusion법은 적용이 간편한 장점이 있으나 골유착의 재발로 인한 교정치료의 실패가능성이 높은 단점이 있다. 본 증례는 다수치의 부분맹출 및 골유착으로 인한 구치부 개방교합이 주소인 환자로 소구치는 통산적인 교정치료법으로 골유착된 대구치는 subluxation & extrusion법을 적용하여 양호한 치료 결과를 얻을 수 있었다.

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Rehabilitation with orthognathic surgery and orthodontic treatment in patient with severe occlusal disharmony: A case report (심한 교합 부조화를 보이는 환자에서 악교정수술 및 교정치료를 동반한 구강회복: 증례 보고)

  • Jung-Jin Lee;Kwang-Yeob Song;Seung-Geun Ahn;Ju-Mi Park;Jae-Min Seo
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.204-214
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    • 2023
  • The occlusal treatment including prosthetic treatment should be considered when the pathologic symptom was observed with the excessive discrepancy between the centric relation occlusion (CRO) and the maximum intercuspal position (MIP). Through careful diagnosis, the malocclusion and interarch relationship can be analyzed, and occlusal adjustment, restorative treatment, orthodontic therapy, or orthognathic surgery can be performed depending on the degree of disharmony. The patient in this case report complained the unstable occlusion and loss of masticatory function that had been occurring for several years. At the time of the visit, the patient showed severe occlusal disharmony, with only the upper right second molar contacting the lower jaw at the maximum intercuspal position. Based on the analysis of the occlusion, it was difficult to solve the problem with just occlusal adjustment or restorative treatment. In addition, the patient had the skeletal class II malocclusion between the upper and lower jaws. Therefore, for resolving the severe skeletal class II malocclusion, pre- and post-orthodontic treatment, bilateral sagittal split ramus osteotomy (BSSRO) was performed. After that, the occlusal adjustment was performed for stable occlusion, and the missing teeth area was restored with dental implants. During the follow-up period, a periodic follow-up visits and additional occlusal adjustments were performed to achieve a stable centric occlusion and harmonious anterior and lateral guidance. As a result, the final prosthodontic treatment was completed, and the patient's masticatory function was restored.

Full mouth rehabilitation in partially edentulous patient with an unstable mandibular position (불안정한 하악위를 가진 부분 무치악 환자에서 전악 수복 증례)

  • Donghwi Yook;Younghoo Lee;Seoung-Jin Hong;Ahran Pae;Kwantae Noh;Hyeong-Seob Kim;Kung-Rock Kwon;Janghyun Paek
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.308-315
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    • 2023
  • In the case of a patients who have lost the centric stop and have a staggered occlusion of the residual teeth, various movements occur when the denture is loaded. Implant placement is necessary to reinforce the retention, support, and stabilization elements to reduce denture movement. However, in this case, considering the patient's age, aversion to surgery, and bone loss, implants were not placed and restoration was performed with a removable partial denture. In this case, it is important to set the correct mandibular position for restoration because the patient has a habit of chewing with the remaining teeth. In this case, a stable mandibular position was established using a gothic arch tracing, and good results were obtained by restoring with partial dentures, so this is reported.

Fit of Fixture/Abutment/Screw Interface of Internal Connection Implant Systems (수종의 내측연결 임플랜트 시스템에서 고정체-지대주-나사계면의 적합에 관한 연구)

  • Shim, Deok-Bo;Kim, Hee-Jung;Oh, Sang-Ho;Chung, Chae-Heon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.3
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    • pp.283-298
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    • 2008
  • The purpose of this study was to evaluate mechanical fit of fixture- abutment-screw interface in the internal connection implant systems. In this study, each two randomly selected internal implant fixture- abutment assemblys from Certain, Xive, Replace, Ankylos, SS II. were used. The implants were perpendicularly mounted in liquid unsaturated polyester by use of dental surveyor. Each abutment was connected to the implant with recommended torque value using a torque controller. All samples were cross-sectioned with grinder-polisher unit after embeded in liquid unsaturated polyester, and then fixture-abutment-screw interfaces of all samples by using optical microscope and scanning electron microscope were analyzed. Conclusively, although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal fixture-abutment connections which provides intimate contact with the implant walls to resist micromovement, resulting in a strong stable interface.