• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.25-34
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• 2016

Treatment of missing mandibular 4 incisors is often thought to be easier then other place during surgical and prothetic procedure. But clinicians encounter unexpected difficulties such as restricted implant site due to mesio-distal width of mandibular incisors, limited space as a result of crowing and mesial drift, esthetic problem after severe alveolar bone resorption, and difficulties of provisionalization Through cases, possible treatment options for missing mandibular incisors would be discussed. Treatment options for missing mandibular 4 incisors Place narrow type implant or one body mini implant on exact tooth position when there is no bone resorption Regular size implant on interseptal bone area when there is severe bone resorption Consider using resin bonded bridge(resin retained bridge/resin bonded fixed partial denture) as a tentative prosthesis when patient resists extracting remaining incisors with poor prognosis.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.4
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• pp.306-313
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• 2013

Speech is complex psycho-physiological mutual process which includes many orofacial organs. Especially, teeth play an especially important role as an articulation organ in conjunction with the lips and tongue. When teeth are missing, the position of tongue and mandible is adjusted to produce correct sound. If a patient's adaptive function is inadequate for modification of malocclusion, prosthodontic and orthodontic interventions are necessary. Missing teeth of young patients should be reconstructed bacause it can cause malocclusion, decreased masticatory efficiency, articulation disorders, esthetic problem, and temporomandibular disorder. Valplast$^{(R)}$(Valplast International Corp, New York, USA) flexible denture is useful for rehabilitation due to its excellent physical properties, esthetics, and small volume. This case is regardingan intellecturally disabled patient with anarticulation disorder caused by missing lower incisors due to trauma. The patient showed improvement in articulation by using flexible partial denture. The purpose of this report is to figure out the influence of missing lower anterior teeth on articulation.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.2
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• pp.56-63
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• 2022

The mandibular 4 anterior incisor restoration has small teeth and a small space, so the choice of abutment is always a concern. The mandibular 4 anterior incisor extraction is caused by periodontal disease, interdental embrasure greatly open is advantageous of oral hygiene management. Try to make it small diameter with custom abutment, it is limited to the space for the screw. Rather than setting the post site of one body implant to a horizontal cross-section, it is advantageous to set it to a longitudinal cross-section, for interdental embrasure formation. When using an internal bone level implant, rather than using a two-piece abutment, using a one-piece abutment can more effectively secure space for interdental embrasure.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.87-101
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• 2015

The premature loss of the mandibular primary canine is relatively frequent and a sign of the upcoming space problems in the transitional period. This situation is caused by the permanent lateral incisor resorbing the root of the primary canine during its eruption. Bilateral loss of primary canines in a crowded arch leads to the lingual tipping of the permanent incisors, with the consequent reduction in the arch perimeter and increase in overbite. When the loss of a primary canine is unilateral, tipping of the adjacent incisors occurs toward the space, resulting in midline deviation. In these situations, treatment possibilities, such as extraction of the antimeric tooth or placement of a passive lingual arch, can be applied; although there are some controversies concerning this. Most space problems with less than 4 mm can be resolved through preservation of the leeway space using sequential disking of the primary teeth and a passive lingual arch, regaining space or limited arch expansion in the late mixed dentition. In cases with 4~6 mm of space problems, arch expansion (A-P or transverse) can be applied. Space problems with more than 6 mm should be treated through diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth including serial extraction (guidance of eruption).

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.404-411
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• 2022

The patient in this case was an 80-year-old female who had lost #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 teeth. The patient showed loss of posterior support, loss of vertical dimension of occlusion, and deep anterior overbite. Her chief complaint was esthetic and functional discomfort. She wanted to restore normal facial aesthetic shape and masticatory function through prosthetic treatment. Clinical evaluation, radiographic examinations, and facial and oral analysis were performed. Interocclusal rest space was excessive than the average. Distance between labial vestibules and zenith of central incisors, and lower facial ratio were below the average. Taken together, occlusal rehabilitation was determined through increasing 4 mm of vertical dimension on premolars. In this case, a patient who lacked restoration space with deep bite in the anterior region due to loss of the posterior teeth support restored a stable occlusal relationship and harmonious anterior and lateral guidance through fixed and removable prosthesis with increased vertical dimension.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.382-388
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• 2019

Increased anterior teeth mastication following posterior teeth loss leads to greater anterior occlusal force. It may cause greater attrition of anterior teeth, traumatic force occlusion (TFO), also often followed by antagonist extrusion and occlusal disharmony. This clinical report describes the treatment for a 67-year-old female patient diagnosed with loss of both maxillary and left mandibular posterior teeth, severe attrition of maxillary and mandibular anterior teeth and extrusion of multiple teeth. A diagnostic cast was mounted on articular in centric relation (CR) position to evaluate vertical dimension (VD) and interspace. To provide adequate space for the prosthetic reconstructions, VD was increased by 3 mm on the anterior pin. And then diagnostic wax-up was completed upon that VD. Wax-up was converted to provisional restorations and verified in the patient's mouth and the final restorations were delivered. Clinical follow up examination held 3 months after temporary restoration owing to changes in vertical dimension revealed proper function in mastication without evidence of temporo-mandibular joint (TMJ) disorders. This clinical report presents successfully restoring severe attrition case with increasing vertical dimension resulting in satisfaction in esthetics and function.

• 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.

• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.47-61
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• 2004

Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root Is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages $10\~15$ without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.347-353
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• 2018

Gradual attrition is a normal process of aging, but severe attrition causes occlusal disharmony, functional disorder and esthetic problems. The collapse of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). And it induces the pathologic change of the TMJ, unaesthetic facial appearance and decreased masticatory function. In this case, 70 year-old male presented with decreased vertical dimension and esthetic problems due to worn dentition. Based on assessment of intraoral findings, diagnostic cast and radiographic examination, full-mouth rehabilitation with increase of OVD was planned. After 10 month follow-up, occlusal stability is maintained and through this procedure, satisfactory outcomes were achieved in esthetic and functional aspects.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.4
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• pp.244-252
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• 2019

Proper positioning of maxillary incisors is key to success of surgery combined treatment. Establishing surgery plan would be a difficult job if maxillary incisors are lost. Patient who lost all of her maxillary incisors due to accident came for orthodontic treatment. Through careful modification of maxillary archform, pre-surgical orthodontic treatment was conducted with four prosthetic space consolidation. Position of incisors was decided by help of 3D prosthetic set-up, and 1-jaw surgery was planned. After relative short treatment period of 28 months, final prosthesis was done. When alveolar bone loss happens, harmonious prosthesis of upper incisors is difficult. Utilizing mandibular set-back surgery and incisor positioning using 3D set-up could make a better environment for treatment outcome. Strategic pre-surgical orthodontic treatment can allow shorter time and less number of prosthetics.