• Journal of Oral Medicine and Pain
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• v.46 no.4
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• pp.155-160
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• 2021

The masticatory muscle disorder is the most common problem that patients with temporomandibular disorder often complain. For such complaints, treatment is directed towards reducing hyperactivity of muscles or effects of the central nervous system. However, if nonspecific occlusal change or pain persists, it is necessary to consider that muscle weakness might be the cause of the persistence of temporomandibular disorder. Stabilization of occlusion and improvement of the pain symptoms were achieved in both cases through the chewing gum exercise. This exercise may enable masticatory movements done in normal function by using muscle engram and achieve reinforcement of the masticatory muscles with balanced, simultaneous contacts of the teeth. In addition, it may be a viable method for treating temporomandibular disorders that do not respond well to conventional mandibular stabilization therapies.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.83-94
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• 2004

The purpose of this study was to compare the distributing pattern of stress according to the types of occlusal load on the finite element models of the splinted implant prostheses. The finite element model was designed with the parallel placement of two fixtures ($4.0mm{\times}11.5mm$) on mandibular first and second molars. The cemented crowns for mandibular first and second molars were made. Three-dimensional finite element model was created with the components of the implant, surrounding bone and cemented crowns. Two types of occlusal load, the point load and the surface load within 0.5 mm radius circle, were applied to the finite element models with 200N magnitude in axial(along the long axis of the implant and oblique(angulation of $30^{\circ}$ to the long axis) directions perpendicular to cuspal incline. Loads were positioned from the center of central fossa and to distance of 2 mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures and sections. The results were as following : 1. Under axial loading at the central fossa, the stress was distributed along the fixture except for the apical portion, not relative to both point & surface contacts. 2. With offset distance increasing, the highest stresses were concentrated in the neck portion of the fixture. 3. The maximum von Mises stress under the oblique load was greater than that under the axial load. 4. Under the oblique load, the highest stress were concentrated in the buccal side and lingual neck portion of the fixture with offset distance increasing. The results had a tendency to increase the stress on the neck portion of fixture with the offset and oblique loads increasing. The design of occlusal scheme should be allowed to distribute stress axially in maximum intercuspation and to decrease the angulation of cuspal incline.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.77-90
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• 1990

The purpose of this study was to compare the amount of the vertical pin opening of $33^{\circ}$ resin and $0^{\circ}$ resin teeth during processing and to determine whether the changes in tooth contacts by using articulation ribbon and T-Scan system follow any identifiable pattern, and to determine if there is any correlation between the changes in tooth contacts and the amount of the vertical pin opening after processing. Through statistical analyses on the data from this study, the following conclusions were obtained. 1. The amounts of the vertical pin opening were 0.78m, 0.87mm for $0^{\circ}$ teeth and $33^{\circ}$ teeth, respectively. But there was no significant difference between them. 2. The total number of contact points recorded by articulating ribbon after processing was decreased to 442.5% of that before processing. 3. The mean values for the number of contact points per tooth recorded by articulating ribbon after processing were 4.3 for the second molar, 3.8 for the first molar, 1.3 for the second premolar, 0.8 for the first premolar. The reduction of contact points per tooth became greater moving in an anterior direction. 4. The correlation between the reduction of contact points and the amount of the pin opening after processing was not significant. 5. The mean values for the numbers of contact points per tooth recorded by T-Scan system after processing were 2.2, 2.5, 1.0, and 0.5 at the second molar, the first molar, the second premolar, and the first premolar, respectively. 6. The correlation between the number of contact points by using articulating ribbon and TScan system after processing was not significant.

• Journal of Oral Medicine and Pain
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• v.14 no.1
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• pp.57-66
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• 1989

66 patients with temporomandibular disorders were selected for experimental group, and 45 normal subjects who were Dental students were selected for control group. Average age of experimental group was 30.5 years, Male to Female ratio was 2 : 3, and their age distribution were teen-ages to seventh decades. Transcranial radiography (TR) with Denar Accurad 100 was used for each group to get the values of width in joint spaces and to investigate the bony changes of articular surfaces and relative condylar position to articular fossa. In addition to TR, clinical interview and routine charting about amount of mandibular movements and occlusal variations were carried out in experimental group. The obtained results were as follows : 1. The mean values of joint space with in control group were 2.15mm to anterior, 2.98mm to superior and 2.29mm to posterior and the value of relative condylar position to the deepest portion of articular fossa was 0.21mm to anterior. In experimental group, those values were 2.01mm, 2.14mm 2.22mm and 0.12mm to posterior in sequence, respectively. Joint spaces in experimental group, therefore, were inclined to decreased, and relative condylar position was inclined to retrude. Joint space in control group showed symmetric condylar position, but in experimental group showed asymmetry. 2. Non-affected joints with no bony changes in experimental group showed the narrowest joint spaces which were thought to manifest the abnormal stress to non-affected side to dysfunctional state of contralateral affected joints. 3. Amount of mandibular movements in experimental group were within normal values in lateral movements and in protrusive movement but in opening movement with or without passive stretch, those were lower than normal values. Frequency of occlusal variation, for example, protrusive posterior contacts, open bite, median line shift to lateral side were inclined to increase with bony changes and with crepitus.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.187-197
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• 2017

Deep overbite patients who do not have proper occlusal relationship may cause problems such as teeth wear and antagonist extrusion. These lead to the collapse of occlusal plane and esthetic problem. Increasing vertical dimension is frequently essential to resolve those problems. This case report demonstrates a full-mouth rehabilitation for a patient with severe deep bite that contacts surface to surface by increasing vertical dimension. Treatment procedures included diagnosis, treatment planning, implant surgery, and prosthodontic rehabilitation. Satisfactory results were obtained in functional and esthetic aspects.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.71-81
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• 2004

The purpose of this study was to compare the distributing pattern of stress on the finite element models of two units implant prosthesis with one angulated placement of two implant fixtures. The two unit implant crowns simulated to mandibular first and second molars were made. The two kinds of finite element models were designed according to angulation of fixture ($4.0mm{\times}11.5mm$) : Model 1($15^{\circ}$ buccally angulated placement of one fixture on second molar area), Model 2($15^{\circ}$ lingually angulated placement of one fixture on second molar area). Axial loads of 200N were applied to the center of central fossa and to distance of 2mm and 4mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures, and buccolingual section of implants. The results were as follows: 1. Under axial loading at the central fossa, the stress was distributed along the straight fixture except apical portion, while on buccally or lingually angulated placement, the highest stresses were concentrated in the neck portion on the opposite side of the angulated fixture. 2. With offset distance increasing, the stresses were concentrated greater in buccal neck of lingually angulated fixture than in lingual neck of buccally angulated fixture. From the above results, in designing of the occlusal scheme for implant prosthesis with the angulated fixture, occlusal contacts should be placed to distribute stress axially in maximum intercuspation and to avoid offset force during eccentric movements.

• The Journal of Advanced Prosthodontics
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• v.9 no.1
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• pp.45-51
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• 2017

PURPOSE. This study aims to investigate the effects of four different lateral occlusion schemes and different excursions on peri-implant strains of a maxillary canine implant. MATERIALS AND METHODS. Four metal crowns with different occlusion schemes were attached to an implant in the maxillary canine region of a resin model. The included schemes were canine-guided (CG) occlusion, group function (GF) occlusion, long centric (LC) occlusion, and implant-protected (IP) occlusion. Each crown was loaded in three sites that correspond to maximal intercuspation (MI), 1 mm excursion, and 2 mm excursion. A load of 140 N was applied on each site and was repeated 10 times. The peri-implant strain was recorded by a rosette strain gauge that was attached on the resin model buccal to the implant. For each loading condition, the maximum shear strain value was calculated. RESULTS. The different schemes and excursive positions had impact on the peri-implant strains. At MI and 1 mm positions, the GF had the least strains, followed by IP, CG, and LC. At 2 mm, the least strains were associated with GF, followed by CG, LC, and IP. However, regardless of the occlusion scheme, as the excursion increases, a linear increase of peri-implant strains was detected. CONCLUSION. The peri-implant strain is susceptible to occlusal factors. The eccentric location appears to be more influential on peri-implant strains than the occlusion scheme. Therefore, adopting an occlusion scheme that can reduce the occurrence of occlusal contacts laterally may be beneficial in reducing peri-implant strains.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.4
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• pp.321-329
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• 2002

Bending moments results from offset overloading of dental implant, which may cause stress concentrations to exceed the physiological capacity of cortical bone and lead to various kinds of mechanical failures. The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different angulated placement of dental implant in mandibular posterior missing areas. The three kinds of finite element model, were designed according to 3 main configurations: Model 1(parallel typed placement of 2 fixtures), Model 2(15. distal angulated placement of one fixture on second molar area), Model 3(15. mesial angulated placement of one fixture on second molar area). The cemented crowns for mandibular first and second molars were made on the two fixtures (4mm 11.5). Three-dimensional finite element models by two fixtures were constructed with the components of the implant and surrounding bone. A 200N vertical static load were applied to the center of central fossa and the point 2mm apart from the center of central fossa on each model. The preprocessing, solving and postprocessing procedures were done by using FEM analysis software NISA/DISPLAY IV Version 10.0((Engineering Mechanics Research Corporation, USA). Von Mises stresses were evaluated and compared in the supporting bone, fixtures, and abutment. The results were as following : (1) Under the point loading at the central fossa, the direction of angulated fixture affected the stress pattern of implants. (2) Under the offset loading, the position of loading affected more on the stress concentration of implants compare to the angulated direction of implants. The results had a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the placement angulation of implant fixture is placed toward mesial or distal direction. In designing of the occlusal scheme for angulated placement, placing the occlusal contacts axially during chewing appears to have advantages in a biomechanical viewpoint.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.322-329
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• 2016

Reconstruction of the maxillectomy with an obturator is to restore masticatory, swallowing, phonetic and esthetic problems. Stress created by lateral forces is minimized by the proper selection of an occlusal scheme, elimination of premature occlusal contacts, and wide distribution of supporting area. It should be considered that properly designed retainers reduce the stresses transmitted to the abutment while the obturator is in function. The following clinical report presents palatal obturator treatment with implant assisted removable partial denture (IARPD) design that restores normal function and esthetics in patients who experienced maxillectomy and dental implant failure.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.3
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• pp.189-200
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• 2024

In patients with newly established ideal occlusion through full-mouth rehabilitation using fixed prostheses, complications and occlusal changes over time can arise because of various factors. This case report describes a 10-year follow-up of a patient with masticatory dysfunction and aesthetic problems who underwent full-mouth rehabilitation with an increased vertical dimension. During the follow-up, complications such as tooth fracture, occlusal changes, infraocclusion of few implant-supported prostheses, and loss of interproximal contacts were observed. Detecting these issues early through periodic follow-up is important. This case report aims to review the causes of complications after full-mouth rehabilitation using fixed prostheses and the strategies for their management.