• Title/Summary/Keyword: Esthetic diagnosis

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Full mouth rehabilitation of the elderly patient on anticoagulant medication with loss of vertical dimension due to severely worn dentition (전반적인 치아 마모로 수직 고경이 상실된 항응고제 복용 고령 환자의 전악 수복 증례)

  • Kang, Cheol-Keun;Heo, Seong-Joo;Kim, Seong-Kyun;Koak, Jai-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.56-63
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    • 2018
  • Severe dental attrition causes pathological changes of the tooth, collapsed occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension. Before increasing the vertical dimension with full-mouth rehabilitation, it is important to determine the amount of vertical dimension through accurate diagnosis. In this case, a 77 year old elderly male patient on anticoagulant medication with generalized attrition and fracture of teeth was treated with full-mouth rehabilitation in order to recover vertical dimension and aesthetics. Accurate clinical and radiographic examination, diagnostic, wax-up, and occlusal vertical dimension evaluation were step by step performed considering pre-medical history and old age. Patient adaptability was evaluated using an occlusal splint and interim restoration. After 3 months of stabilization with interim restoration, definitive prostheses were fabricated. Satisfactory functional and esthetic outcomes are observed after 6 months of follow up.

Evaluation of Stability Following Two-Jaw Surgery (양악 수술 후 안정성 평가)

  • Lee, Sung-Yong;Kim, Su-Gwan;Kim, Seo-Yoon;Oh, Ji-Su;Moon, Kyung-Nam;Yoon, Dae-Woong;Kim, Hoon;Kim, Jeong-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.137-143
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    • 2011
  • Purpose: Orthognathic surgery is required in patients with severe skeletal disharmony and facial asymmetry, which results in functional and esthetic improvement. Recently, bimaxillary surgery has become generalized. Establishment of the occlusal plane among several other factors included in the surgery plan is a major consideration for the diagnosis and treatment plan and it is also an important factor for postoperative stability. Methods: In this study, we assessed postoperative stability of occlusal plane, B-point, and pogonion point on 20 patients who underwent two-jaw surgery in the Chosun Dental Hospital from 2000 to 2007. Preoperative and postoperative states and at least a one year postoperative follow-up were compared. Results: The postsurgical relapse volume of the occlusal plane to the SN plane and the FH plane was $-0.26{\pm}2.8^{\circ}$ and $-0.44{\pm}3.29^{\circ}$, respectively and after two-jaw surgery, the stability of occlusal plane was maintained. The horizontal relapse degree was $0.85{\pm}0.46$ mm and $0.76{\pm}0.48$ mm, respectively, and the vertical relapse degree was $1.16{\pm}0.36$ mm and $1.13{\pm}0.71$ mm of the B point and the Pogonion point at the time after minimal 1 year. Conclusion: The vertical relapse amount was shown to be slightly larger than the horizontal relapse amount.

Characteristics of Facial Skin Surface According to Sasang Constitution Classification (사상체질에 따른 피부 표면 상태 분석)

  • Choi, Eun-Young
    • Proceedings of the KAIS Fall Conference
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    • 2010.11b
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    • pp.878-881
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    • 2010
  • For better diagnosis and prescription in Korean traditional medicine, Lee Je-Ma (1837-1900) created Sasang Constitution classification which was divided into four groups of Taeyangin, Soyangin, Taeumin and Soumin based on both body shape and natural disposition. The purpose of this study was to investigate the characteristics of facial skin parameters (hydration, lipid and pH) on forehead and cheek according to Sasang Constitution classifications of Taeumin, Soyangin and Soumin in Korean. Eighty-nine Korean female subjects were recruited for this study and the average age of them was 19.9${\pm}$0.84 years. The four groups by the Sasang Constitution were classified by questionnaire for the Sasang Constitution classification proposed by Kyung-Hee Oriental Medicine Hospital. Consequently, thirty-eight (42.7%) among the subjects were grouped into Soumin, twenty-nine (32.6%) into Taeumin, twenty (22.5%) into Soyangin and two (2%) into Taeyangin. Taeyangin group was excluded from statistical analysis due to small subjects. Hydration, lipid and pH parameters on forehead and cheek were measured by using non-invasive instruments of Corneometer (CM 825, Schwarzhaup, Germany), Sebumeter (SM 815, Schwarzhaup, Germany) and Skin-pH-meter (pH 905, Schwarzhaup, Germany), respectively. The measurements by the same investigator were performed under standardized condition with a room temperature of $21^{\circ}C$ and a humidity level of 40% to 50%. As a result, hydration (F=25.481, p=.000), lipid (F=5.753, p=.005) and pH (F=5.010, p=.009) of the forehead skin showed significant differences in the order of Taeumin, Soyangin and Soumin. Hydration (F=23.216, p=.000), lipid (F=6.898 p=.002) and pH (F=5.070, p=.008) of the cheek skin showed significant differences in the order of Taeumin, Soyangin and Soumin. In conclusion, facial skin surface seemed to be dependent on Sasang Constitution classification in Korean. These findings indicated that Sasang Constitution classification might be an useful esthetic treatment for caring facial skin in the future.

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ESTHETIC MANDIBULAR ANGLE REDUCTION ; IST USE AND COMPLICATIONS (하악 우각부 미용 성형술 ; 임상적 응용과 병발증)

  • Kim, Chang-Soo;Um, In-Woong;Min, Byoung-Kuk;Min, Seong-Kee;Yang, Yun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.137-143
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    • 1991
  • The bulging of mandibular angle area, frequently, make some difficulties in social life due to its reckless appearence, especially in oriental nations. So, many authors had reported its causes and surgical techniques for correction since late 19th century with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental myotomy as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possible complications.

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CONSIDERATIONS OF ORTHODONTIC ASPECT IN THREE LOWER INCISOR CASES (하악 3 절치 증례의 교정학적 고려 사항)

  • Chang, Young-Il;Baek, Seung-Hak;Park, Kyung-Jin
    • The korean journal of orthodontics
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    • v.24 no.4 s.47
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    • pp.759-772
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    • 1994
  • Orthodontists have experienced the treatment of cases with three lower incisors. Occasionally a lower incisor was either congenitally missing or so seriously damaged by injury or disease that its removal presented the best prospect for the patient. Sometimes the intentional extraction of a lower incisor is needed to produce enhanced functional and esthetic results with minimal orthodontic manipulation. Such cases have unfavorable anterior tooth size discrepancies and present difficulties in achieving good occlusal results. However such difficulties can be overcome by the sensible diagnosis and treatment plan. Three different cases are presented and the conclusions are listed. 1. It is important for orthodontist who tries to treat three lower incisor cases to measure and calculate accurately the degree of deviation of tooth size and morphology and the anterior tooth size ratio. 2. A diagnostic setup model should be made to determine whether the incisor extraction is appropriate and space closure is needed or not. It is the best way to be sure that the occlusal results, including overbite and overjet, will be acceptable and how far the degree of midline deviation is. It also shows the amount of interproximal reduction to achieve an acceptable occlusal result. 3. The class I relationship between the upper canine and the lower one must be obtained to establish the canine rise during eccentric movement by the concept of mutually protective occlusion. It also helps to maintain the stable occlusal result.

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Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report (심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례)

  • Kim, Seong-A;Noh, Kwantae;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.79-87
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    • 2017
  • The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

Full mouth rehabilitation with vertical dimension elevation in the patient with severely worn dentition: case report (과도한 치아 마모 환자에서 수직고경 증가를 동반한 전악 수복 증례)

  • Lee, Eun-Jee;Shin, Soo-Yeon
    • 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.

CORRECTION OF SECONDARY LIP DEFORMITIES IN CLEFT PATIENTS (구순열 환자의 이차 구순 성형술)

  • Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.401-406
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    • 1999
  • Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.

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SEQUENTIAL METHOD FOR SETTING SURGICAL TREATMENT OBJECTIVES (Sequential Method for setting Surgical Treatment Objective STO수립을 위한 순차적 방법)

  • Choi, Byung-Taek
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.440-455
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    • 2002
  • The final goal for an orthognathic surgery is a functional and esthetic achievement based on occlusion theory. All the dental treatment should be done with the occlusion in mind, though, they tend to be ignored with no good reason. We cannot think of occlusion without temporomandibular joint because it is the first clue to define an occlusion. As normal occlusion comes from the central tendency of distribution of population, we can get it by examining the population that closely meet the criteria of ideal occlusion. To perform proper occlusal function and to maintain the stability after treatment, the case must be finished in normal occlusion closer to ideal one. Our aim is to achieve the ideal occlusal scheme like the mutually protected occlusion with the best masticatory efficiency and the stability. The facial esthetics are influened by culture, race and the time in which human live. While the occlusal function rarely changes as time goes by, esthetics tend to do from one country to another. Orthodontists and maxillofacial surgeons should have solid sets of treatment goals to achieve the best facial esthetics and the ideal occlusion dictated by the joint. Doing orthognathic surgery, two factors aforementioned should be taken into account to establish the Surgical Treatment Objectives(STO). The doctors who are planning orthognathic surgery need to have a very logical and systematic thought process to make STO. The author examined 28 selected beautiful Korean female adults with normal skeleton with normal occlusion and analyzed the hard and the soft tissue relationship into five parts : dentomaxillary relationship, intermaxillary relationship, posture to hard tissue relationship, facial balance, and posture to soft tissue relationship. This study presents a sequential flow of diagnosis and treatment planning especially for surgical patients and it also can be applied to the nonsurgical patients.

Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth

  • Francio, Luciano Andrei;Silva, Fernanda Evangelista;Valerio, Claudia Scigliano;Cardoso, Claudia Assuncao e Alves;Jansen, Wellington Correa;Manzi, Flavio Ricardo
    • Imaging Science in Dentistry
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    • v.48 no.2
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    • pp.87-96
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    • 2018
  • Purpose: The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods: Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results: For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations(P>.05), but showed no discriminatory ability for amalgam restorations(P<.05). Conclusion: Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.