• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.397-404
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• 2019

Bone and soft tissue conditions are important for successful implant treatment. But, the placement itself is also very important. Implants which is installed in the wrong position result in the biological, esthetical and mechanical problems. In order to place an implant in the correct position, the final restoration and diagnostic wax-up should be considered prior to the surgery. If the artificial teeth for the interim denture are directly transferred from the diagnostic wax-up, the operator can try the form of diagnostic wax-up in the mouth. If the surgical template is produced by duplicating the interim denture, the implant can be placed in the planned position. In this case, the polymethyl methacrylate (PMMA) artificial tooth was precisely milled by the digital duplication of diagnostic wax-up. And interim denture was fabricated by using these milled teeth. After the patient adapted for a sufficient period, the implant was placed at the planned position with surgical template produced by duplicating the interim denture. After confirming sufficient osseointegration, the final prostheses were made to reflect the shape of diagnostic wax-up. Through this procedure, the satisfactory functional and esthetic outcome could be acquired.

• 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.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.53 no.3
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• pp.262-275
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• 2015

The treatment of areas demanding esthetic requirements, such as maxillary anterior teeth, should take into account the achievement of a healthy, harmonious to the surrounding tissue, and an attractive smile line. In this case report, smile line, soft tissue and hard tissue morphology, and the anatomy and proportion of the tooth, must be considered. In patients with unesthetic maxillary anterior ratio due to inadequate gingival contour and diastema caused by peg lateralis, it would be challenging to achieve an esthetic restoration by orthodontic treatment alone. In such case, after orthodontic treatment, dento-gingivo-facial compositional diagnosis and analysis, followed by gingivectomy and prosthodontic restoration is needed to improve the interdental mesial/distal, width/length ratio to achieve a satisfactory esthetic result. In addition, when improving the tooth proportion of peg lateralis by prosthodontic treatment, Porcelain laminate veneer (PLV), which results in less tooth structure loss, reproduction of similar shade to that of the proximal tooth and high transparency, is recommended. This case report demonstrates esthetic improvements by prosthodontic restoration through systematic diagnosis and treatment procedure in patients with unesthetic maxillary anterior proportion after orthodontic treatment due to peg lateralis by means of two female patients aged twenty years old.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.224-231
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• 2016

Severe dental attrition causes pathological changes of the tooth, imbalanced occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension that can incur temporomandibular joint and muscular complications. Before restoring the vertical dimension with full-mouth prosthetic restorations, it is important to determine the amount of vertical lifting through complete diagnosis. In this study, a 59 year-old male patient with generalized attrition and fracture of teeth was treated with full-mouth zirconia prosthetic restoration in order to recover vertical dimension and aesthetics. Through the analysis of physiologic rest position and inter-canine distance, the treatment was planned for lifting 3 mm in vertical dimension. Interim crown were fabricated after full-mouth wax up, having the patient use for 6 months. The final monolithic and bilayered zirconia restorations were completed. The patient showed satisfaction in function and aesthetics for 18 months of follow-up since delivering the final restorations.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.2
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• pp.182-188
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• 2019

A proper vertical dimension and a harmonious occlusal plane are essential to satisfy a patient esthetically and functionally. A maxillomandibular occlusal vertical dimension is determined by the elevators which repeatedly contracts to a certain length, and a tooth location is determined by a maxillomandibular vertical dimension. The patient of this case came in with the incongruity of the lips and the occlusal plane. The result of clinical test showed the lack of length of the lower anterior due to the reduction of vertical dimension, the deep overbite of anterior, the excessive attrition of anterior, and the incongruity of occlusal plane. After the diagnostic wax-up, the temporary restoration was installed, and final prosthesis was installed after 6 months. As a result, the patient obtained a functionally and esthetically satisfying result.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.1
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• pp.40-49
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• 2018

It is reported that the causes of unaesthetic proportion of anterior teeth vary widely. Especially, when the unaesthetic tooth proportion of the mandibular incisors arises due to the wear of the anterior teeth accompanied by the compensation of the alveolar bone, it may cause serious functional and aesthetic problems. In such case, it should be considered that the evaluation of vertical dimension and tooth proportion as well as smile line, soft tissue and hard tissue morphology. And, increase of vertical dimension or clinical crown lengthening followed by prosthodontic restorations is needed to improve the interdental mesial/distal, width/length ratio considering the anterior guidance. This case report demonstrates functional and aesthetic improvements through systematic diagnosis and treatment procedures in a 48-year-old male patient with unaesthetic anterior teeth proportion because of tooth wear accompanied by the compensation of alveolar bone and defect of several central incisors due to chronic periodontitis.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.215-226
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• 2023

Severe wear of the anterior teeth facilitates the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. Additionally, when treating patients with collapsed occlusion due to multiple tooth loss and tooth wear, it is important to determine the presence of vertical dimension loss through accurate clinical and radiographic examinations and diagnostic wax-up. The patient of this case is a 44-year-old female patient who complained of overall tooth wear and loss of posterior teeth due to bruxism and clenching habits, visited the hospital with the address of restoring masticatory function and improving aesthetic appearance through prosthetic treatment. Through model analysis and diagnostic wax-up, an increase in vertical dimension was determined, and full mouth restoration with fixed prostheses was planned. The degree of adaptation to the vertical dimension was confirmed step by step using an occlusal splint designed with CAD (Computer aided design) software and 3-D (3-Dimensional) printed, and then restored with provisional restoration and after a 4-month adaptation period, the entire dentition was restored with metal ceramic crowns and implants. Through this procedure, satisfactory treatment results were obtained in terms of function and aesthetics.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.267-275
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• 2023

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors. Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.