• Title/Summary/Keyword: Mandibular function

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Neutral zone approach for rehabilitation in a patient who underwent mandibulotomy: A case report (하악골 이단술을 시행한 환자에서 중립대를 활용한 상하악 총의치 수복 증례)

  • Heedo Shin;Hag-Young Lee;Jee-Hwan Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.18-25
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    • 2023
  • We present the case of a 65-year-old man with maxillary and mandibular complete dentures prepared using neutral zone technique after undergoing mandibulotomy due to tonsil cancer 10 years ago. The patient had a short edentulous period; hence, there was minimal absorption of the alveolar ridge and no abnormality in the motor function of the tongue. However, the retromolar pad was located inside the hamular notch, and the posterior alveolar ridge was relatively turned inward. If the artificial teeth would have been aligned conventionally, the functional space of the tongue would have been invaded, which would have moved the tongue posteriorly thereby reducing the stability of the denture. Therefore, applying the concept of the neutral zone can be a good reference point in such cases. The neutral zone was registered using tissue conditioner, and tooth alignment was performed by making a silicone putty index. The biggest advantage of using neutral zone concept is denture stability. In this case, the neutral zone technique was applied to obtain the lingual alignment limit of the posterior teeth to avoid invasion of the tongue space by the left posterior part of the mandible. Particularly, in case of a patient in which denture stability is difficult to obtain due to absorption of the alveolar ridge, it is believed that better results can be obtained using neutral zone technique.

Complete denture rehabilitation of partially glossectomized patient using palatal augmentation prosthesis: A case report (부분 혀 절제술을 받은 완전 무치악 환자에서 구개증대보철물을 이용한 수복 증례)

  • Hyeon-Kyeong Lee;Na-Hong Kim;Hee-Won Jang;Sun-Young Yim;Keun-Woo Lee;Sung-Yong Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.82-89
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    • 2023
  • The tongue is one of the most common sites of oral cancer. Glossectomy is known as the gold standard for tongue cancer treatment. However, surgical removal can lead to reduced mobility of the tongue and the patients may have difficulty performing normal oral functions like swallowing and pronunciation. Therefore, additional prosthetic consideration to supplement the function of the impaired tongue is needed for oral rehabilitation of such patients. Palatal augmentation prosthesis helps the tongue to reach the palate by lowering the position of the palatal polished surface. The oral functions of the patients with limited tongue mobility can be improved by the prosthesis. In this case, palatal augmented maxillary denture and conventional mandibular denture were fabricated for the completely edentulous patient with reduced tongue mobility after glossectomy due to tongue cancer. As a result, the oral functions of the patient were improved with the prosthesis.

Oral rehabilitation of a patient with collapsed occlusal plane resulting from loss of posterior teeth (구치부 상실로 인해 교합 평면이 기울어진 환자에서 임플란트를 이용한 구강 회복 증례)

  • Jinwoo Han;Jae-Seung Chang;Se-Wook Pyo;Sunjai Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.165-173
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    • 2024
  • Restoring lost teeth is very important in terms of both function and aesthetics. If tooth loss occurs in the posterior region and the loss of support is persistent, it may cause a gradual shift in the position of the mandible and a change in occlusion. This clinical case attempted to restore support for the posterior teeth with a fixed prosthesis using implants in a patient whose opposing teeth were erupted and the occlusal plane collapsed due to long-term loss of the maxillary left posterior teeth and mandibular right first molars. To correct the occlusal plane of remaining dentition, wax-up of maxillary left posterior teeth was duplicated with acrylic resin and placed on maxilla. Surgical template for implant placement were fabricated using digital technology. After the support of the posterior teeth was restored with the placement of the implant, stable occlusion with temporary restorations was observed for a sufficient time. Afterwards, monolithic zirconia prosthesis was placed on the patient to ensure functional and aesthetic improvement.

Full mouth rehabilitation with vertical dimension increase in patient with excessive worn dentition due to parafunctional mandibular movements: a case report (비기능 하악 운동으로 과도하게 마모된 치아를 가진 환자에서 수직 고경 증가를 동반한 전악 수복 증례보고)

  • JiHoon Park;Seong-A Kim;SunYoung Yim;JooHyuk Bang;HeeWon Jang;YongSang Lee;KeunWoo Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.113-122
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    • 2024
  • The gradual teeth wear with age is a natural phenomenon, but excessive wear beyond physiological levels can lead to vertical dimension loss, occlusal imbalance, temporomandibular joint disorders, and periodontal disease. In such cases, prosthodontic restoration becomes necessary emphasizing the importance of appropriate vertical dimension increase and stable occlusion in central relation (CR). In this case, a 74-year-old patient with clenching and grinding habit had severe teeth wear and after assessing interocclusal distance, wear degree, pronunciation, and facial profile, it was decided to perform full-mouth fixed prosthesis restoration with a 4 mm vertical dimension increase. And the significantly displaced Maximum Intercuspal Position (MICP) caused by parafunctional movements was re-established as a stable mutually protective occlusal relationship at centric relation and after a successful 4 months adaptation to provisional restorations, the final prosthesis was fabricated. During 4months of observation periods, stable occlusion in central relation and mutual protection occlusal relationships were maintained and the patient was satisfied with function and aesthetics, leading to this report.

EFFECT OF LOSS OF INCISAL FUNCTION ON THE GROWTH ACTIVITIES AND ULTRASTRUCTURE OF THE CONDYLAR CARTILAGE IN THE RAT (백서에 있어서 incision 중지가 하악두 연골의 성장 및 미세구조에 미치는 영향)

  • Bae, Yong-Chul;Park, Mae-Ja;Joo, Kang;Kyung, Hee-Moon;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.24 no.3 s.46
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    • pp.569-586
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    • 1994
  • The purpose of this study is to investigate the effect of loss of incisal function on the thickness, growth activities, ultrastructure of the condylar cartilage and on the muscle fibers of masseter superlicialis, anterior belly of digastric muscle in the growing rats. 37 day-old-rats of which incisors had been trimmed every day received soft diet from weaning and were studied by the autoradiography, electron microscopy and muscle histochemistry. The results obtained were as follows : The thickness of the fibrous, proliferative layer in superior, posterosuperior portion of the condylar cartilage was significantly(p<0.01) reduced in experimental groups and the decrease rate of fibrous layer thickness was greater in posterosuperior portion than in superior portion of cartilage and was greater than in proliferative layer. In normal group, more cells of posterosuperior portion moved more rapidly towards the medullary cavity. In experimental group, the labelling index of posterosuperior portion was decreased in proliferative layer at 2 hours, in transitional layer at 1, 2 days, in hypertrophic layer at 4 days after injection relative to posterosuperior portion of control group. But labelling index of superior portion was not different from that of control group at all time course after injection. From the muscle histochemistry, the diameter of type IIB fibers in masseter superficialis muscle, type IIA, type IIB fibers in anterior belly of digastric muscle decreased significantly(p<0.01) relative to controls in experimental group. From electron microscopic study, in the fibrous layer of the posterosuperior portion of condylar cartilage in normal group, many fibroblast like cells near the joint cavity showed extensive remodelling activities in ultrastructure. There was no morphological changes between experimental and control group in all cartilage cell layers of superior portion but cells near the joint cavity in fibrous layer of posterosuperior portion of experimental group showed morphologically inactive state relative to control group.

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Cephalometric study of the components of Cl III malocclusion in children 8-10 years of age (8-10세 아동에서 III급 부정교합의 구성요소에 대한 측모 두부방사선계측학적 연구)

  • Kim, Hyung-Don;Yoo, Dae-Jin;Kim, IL-Kyu;Oh, Seong-Seob;Choi, Jin-Ho;Oh, Nam-Sig;Kim, Eui-Seong
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.159-174
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    • 2000
  • Many treatment approaches of Cl III malocclusion have been introduced and the choice of treatment should be a function of the individual problem, not of the clinician(personal preference, experience and success rate of the operator). Therefore a function of the individual problem should be analysed exactly Much has been written in the orthodontic literature concerning the nature of Cl III malocclusion. It has been reported by many investigators that a Cl III malocclusion occurs in a variety of skeletal and dental configurations by differences of race and age. Lateral cephalometric radiographs of 125 individuals were studied for the presence and distibution of four horizontal components and one vortical component in a manner similar to McNamara. The results were as follows : 1. Cl III malocclusion is not a single clinical entity. It can result from numerous combinations of skeletal and dental components. 2. Maxillary skeletal retrusion was the most common single charateristic of the Cl III sample. 3. Only a small percentage of the cases in this study exhibited maxillary dentoalveolar protrusion. 4. Only a small percentage of the cases in this study exhibited mandibular dentoalveolar retrusion. 5. Mandible was usually well-positioned, but a wide variation was observed. 6. A large percentage of the cases in this study exhibited excessive vertical development. Thus, it appears that in designing the ideal treatment regime, those approaches which might restrict vertical development and promote maxillary horizontal growth could be more appropriate in many cases.

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Usefulness of the Salivary Gland Scan Using $^{99m}Tc$-pertechnetate after Radiotherapy in Patients with Head and Neck Cancer (방사선 치료에 따른 $^{99m}Tc$-pertechnetate를 이용한 이하선과 악하선 기능 검사의 유용성)

  • Kim, Jong-Jin;Hong, In-Soo;Lee, Jong-Young;Kim, Myung-Soon;Sung, Ki-Joon;Park, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.325-331
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    • 1996
  • Purpose : To assess the functional change of salivary gland, recovery of salivary destruction, difference of susceptibility to irradiation between the parotid and sub-mandibular gland, correlation between the xerostomia and excretory rate by irradiation in salivary scan using $^{99m}Tc$-pertechnetate in patients with head and neck cancer. Materials and Methods : We evaluated 19 patients with head and neck cancer who had taken $^{99m}Tc$-pertechnetate salivary gland scan before, during and after radiotherapy. We measured the uptake of radioactivity every 5 minutes for 60 minutes after injection of $^{99m}Tc$-pertechnetate(370MBq). We also evaluated the first excretory function stimulated by 5% citric acid at 30 minutes after injection of $^{99m}Tc$-pertechnetate and then the second excretory function stimulated by 10% citric acid at 45 minutes. Results : The mean uptake curves showed a sharp increase at the 1st week of radiotherapy and then showed a gradual decrease afterwards during radiotherapy. And the mean uptake curves after radiotherapy Persistently decreased on follow up scans without being recovered. The excretory rates decreased gradually as radiation dose increased and were not recovered after radiotherapy. Our study was not satisfactory enough to show the difference of susceptibility to irradiation between the parotid and salivary gland and the correlation between the symptom of xerostomia and the change of the excretory rates. Conclusion : The parotid and submandibular gland scans using $^{99m}Tc$-pertechnetate are useful in the assessment of the functional change of the salivary gland by radiotherapy and predicted the functional change of the salivary gland until 1 year-follow up scan.

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A Comparative Study on the Retention of Implant Overdenture According to the Shape and the Number of Magnetic Attachment (자성 어태치먼트의 형태와 수에 따른 하악 임플란트 피개의치의 유지력에 대한 비교 연구)

  • Seo, Min-Ji;Lee, Joon-Seok;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.169-181
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    • 2008
  • The aim of this study was to compare the retention and stability of implant overdenture according to the shape and the number of magnetic attachment. The experimental groups were designed for the number of implants(1, 2, 4) and shape of magnetic attachments(flat, cushion, dome type) resulting in 9 subgroups. 45 attachments were tested attached to $Br{\aa}nemark$ system implants which were planted on a mandibular model. Each attachment was composed of the magnet assembly embedded in a overdenture sample and the abutment keeper screwed into the implants. Dislodging tensile forces were applied to the overdenture samples using an Instron(cross-head speed 50.80mm/min) in 3 directions simulating function: vertical, oblique, and anterior-posterior. The loading was repeated 10 times in each direction for 45 samples. The values of maximum dislodging force of each subgroup were processed statistically using SPSS V. 12.0 at the 0.05 level of significance. The results of this study were as follows: 1. Flat type magnetic overdenture was the most retentive when subjected to vertically directed forces and dome type was the lest retentive when subjected to obliquely directed forces(p<0.05). 2. In case of planting one implant, flat type had a higher vertically retentive force than anterior-posteriorly retentive force. In case of planting two implants, flat type and dome type had a higher vertically retentive force and in case of planting four implants, flat type and cushion type had a higher vertically retentive force than anterior-posteriorly retentive force(p<0.05). 3. The incremental number of dental implant, without regards to the three types of magnetic attachment shapes, showed higher retention of overdenture(p<0.05). From the results, if a patient need much more retention of implant overdenture, flat type magnetic overdenture would be a good treatment. In case of the bruxism where excessive lateral forces are already present, dome type could be expected to produce better results. In case of planting one implant, flat type is more stable than the other shape of magnet and in case of two implant, flat type and dome type are more stable and in case of four implants, flat type and cushion type are more stable. Planting more than two implants and using flat type magnetic attachment would provide better retention and stability of implant overdenture

CORRELATIONS BETWEEN ORBICULARIS ORIS AND MENTALIS MUSCLE ACTIVITY AND CRANIOFACIAL MORPHOLOGY IN NORMAL OCCLUSION AND CLASS III MALOCCLUSION (정상교합자와 3급 부정교합자에서 구륜근과 턱끝근의 활성과 안면골격 사이의 상관성에 관한 연구)

  • Chang, Chun Sil;Lee, Ki Soo
    • The korean journal of orthodontics
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    • v.22 no.1
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    • pp.253-271
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    • 1992
  • The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.

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Prevalence of Temporomandibular Joint Dysfunction and Malocclusion in 10 - 12 year Old Children (10-12세 아동의 측두하악장애와 부정교합의 유병율에 관한 연구)

  • Lee, Nam-Ki;Choi, Dong-Soon;Lee, Hye-Mi;Cha, Bong-Kuen
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.1
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    • pp.29-40
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    • 2008
  • The purpose of this study was to evaluate the prevalence of symptoms and signs of temporomandibular joint dysfunction (TMD) and malocclusion in 10-12 year old children and to determine if a relationship exists between symptoms and signs of TMD and malocclusion. The subjects were composed of 465 school children (233 boys and 232 girls). Each subject was evaluated with simplified questionnaire and clinical examination to measure symptoms and signs of TMD and malocclusion. The results showed an elevated prevalence of headache (34.6%), which were more frequent in girls than boys. The most common cardinal sign of TMD was clicking (32.9%), which increased with age. TMJ lateral tenderness was present in 18.1% of the subjects and had a tendency to increase with age. Masseter muscle tenderness was found to be sensitive in 15.1%of the subjects and had a tendency to increase with age. Restriction of mandibular mobilitywas present in 30.3% of the subjects and had a tendency to increase with age. There was no significant difference in the prevalence of TMD signs between sex. The occlusal status showed Class I malocclusion in 73.3%, Class III in 12.9%,Class II division 1 in 11%, Class II division 2 in 2.8%. There was no significant difference in malocclusion traits between sex. There was statistically significant relationship between TMD signs and symptoms and class II division 1 and Class III malocclusion(p<0.05). The results indicate that the prevalence of TMD symptoms and signs in children is high, and the evaluation of TMD in children seems to be important.