• 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.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.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.50 no.3
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• pp.198-203
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• 2012

Excessive occlusal wear results in unacceptable damage to the occluding surfaces, and can cause pulpal injury, occlusal disharmony, impaired function, and aesthetic deformity. Patients with severely worn dentition need to be classified as several categories relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. When treating patients classified as those who have excessive wear without loss of occlusal vertical dimension but with limited space, we could consider treating them at an increased vertical dimension of occlusion. Treatments at an increased vertical dimension of occlusion may provide stability, given that the amount of its increase was minimal, and a perfected occlusion was achieved after enough stabilization period. A 50-year-old male visited the department of Prosthodontics in Yonsei University Dental Hospital with the chief complaint of worn teeth on lower anterior area. Reconstruction at an increased vertical dimension of occlusion was planned. After the compatibility of the new vertical dimension of occlusion had been confirmed under interim fixed restorations, definitive fixed restorations composed of full-contour monolithic zirconia prostheses were placed. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition at an increased vertical dimension of occlusion with an improvement in esthetics and function.

• 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.

• 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.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.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.301-312
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• 2022

In an extensive oral rehabilitation, determining a proper occlusal vertical dimension is a critical step and the starting point for successful treatment. Since changing the occlusal vertical dimension could be time-consuming, financially challenging, and physically demanding for both clinicians and patients, multi-faceted analysis and careful consideration are essential in the diagnosis and further treatment process. The purpose of this narrative review is to discuss the occlusal vertical dimension and its current issues, and to summarize previous methods of evaluating occlusal vertical dimension to propose clinical guidance for determining a viable occlusal vertical dimension for full-mouth rehabilitation.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.315-323
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• 2014

Excessive teeth abrasion causes pathologic changes of oral environment and masticatory system due to decrease in occlusal vertical dimension. When establishing new occlusal plane and recovering vertical dimension, accurate diagnosis and analysis are essential. In this case, after appropriate centric relation in elevated vertical dimension was taken using Gothic arch tracer, full mouth rehabilitation was performed. A 70-year-old male patient had the chief complaint that he could not eat due to teeth wear. He showed generalized teeth wear and decreased vertical dimension. Elevation of vertical dimension was planned by model analysis. According to increased vertical dimension, centric relation was recorded using Gothic arch tracer and temporary prostheses were applied. Appropriate occlusion was established by temporary prostheses for 4 months. Final prostheses were fabricated using vertical dimension adapted by temporary prostheses. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.132-139
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• 2016

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.