• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.2
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• pp.93-101
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• 2016

The average life expectancy has been increased, so the proportion of elderly patients that visit to the dental clinic for prosthetic restoration has increased. Elderly patients have various chronic diseases. Recent trends show an increase of osteoporosis in elderly patients, and thus, the number of osteoporosis patients is expected to escalate. Currently, the most widely used drug for osteoporosis is bisphosphonate. However, osteonecrosis of the jaw has been reported as a side effect derived from longterm oral administration or injection treatment of the drug. Surgical dental treatment was the main cause of medication related osteonecrosis of the jaw (MRONJ). As MRONJ is very difficult to cure, it is important to take preventive measures. Surgical operation may be needed for the mouth preparation before prosthetic restoration. For successful treatment, the dentist should have a full understanding of osteoporosis and show a continued interest toward this disease for careful management.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.302-307
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• 2018

Multiple tooth loss and excessive occlusal wear can result in damage to occlusal disharmony, functional disorders and esthetic problems, requiring comprehensive prosthetic treatments. Changing vertical dimension harmonized with surrounding muscle tissue is important. In this case, the patient with loss of vertical dimension caused by severe tooth loss and tooth wear was treated with the analysis of vertical dimension, such as diagnostic model, radiography and various clinical exams. the patient was satisfied with favorable functions and esthetics for 1 years of follow-up.

• 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.51 no.4
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• pp.332-338
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• 2013

Data collection including checking the problem list and analyzing the etiology cannot be overemphasized in full mouth rehabilitation cases. It is well reported that favorable prognosis of prosthodontic treatment depends on accurate diagnosis. Seventy seven year old female patient presented with chief complaints of chewing pain on maxillary and mandibular left premolars and unesthetic existing prosthesis. Clinical evaluation, radiographic examination and cast analysis were performed to gather comprehensive data and problem lists. Treatment planning was based on collected data and related articles. Abutment evaluation, prognosis depending on various types of prosthesis, and maintenance were considered as well. Occlusal vertical dimension was increased to solve esthetic dissatisfaction and insufficient interocclusal space. Patient adaptation was verified with provisional restorations followed by diagnostic wax up. Function, esthetics and occlusal stability were verified during 8 week follow-up period. Prosthodontic reconstruction based on systemic analysis, diagnosis, and treatment plan led to satisfactory result after delivery of definitive prosthesis.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.39-46
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• 2013

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. 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.61 no.1
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• pp.33-43
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• 2023

Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.3
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• pp.142-148
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• 2024

Purpose: The purpose of this study was to investigate the accuracy of digital mounting with occlusal scans in the interocclusal record for a full-mouth fixed prosthetic treatment condition. Materials and Methods: The entire maxillary teeth were prepared in a dentiform model and attached to an articulator in maximum intercuspation. Temporary crowns were fabricated and occlusion was adjusted. After scanning the arch with tooth preparation, digital mounting was performed using an occlusion scan of the anterior or posterior teeth areas. The accuracy of the positioned jaw relation was evaluated three-dimensionally through positional deviation and angular error of the occlusal plane. Afterwards, the same procedure was repeated on the partially edentulous model to evaluate the accuracy of digital interocclusal record. Kruskal-Wallis test and Mann-Whitney U test were used for statistical analysis, and the significance level was set at 0.05. Results: There was no significant difference in the positional error at the center of the arch in the digitally established jaw relation depending on the scan area used and remaining tooth conditions (P = 0.53). The angular error of the occlusal plane was larger when the anterior teeth were used as the overlapping area, and a smaller error value was observed when both posterior teeth were used as the overlapping area (P < 0.001). Conclusion: The use of bilateral posterior occlusal scans is recommended when digitally mounting the jaw relation established with temporary teeth during full-mouth fixed prosthetic treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.141-153
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• 2018

A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.381-386
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• 2017

PURPOSE. To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS. Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS. Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION. Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes.

• 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.