• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.3
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• pp.239-245
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• 2003

The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.253-263
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• 2000

We collected age determination cases which were done at Yonsei university dental hospital, department of oral medicine from 1976 to 1999 to analyze it's tendency among Koreans. We analyzed 435 clients cases which were stored by age estimation program from January 1993 to December 1999. The results are as follows: 1. There were no significant difference in the sexual distribution (male : 52.0%, female : 48.0%) and more than half percent (51%) were 20's and 30's. 2. Among the age determination clients, those who wanted to decrease their age (50.3%) and those who wanted to increase their age (49.7%) shows similar in number. And the former case were predominant in the female clients, but the latter case in the male clients. Also the clients below six years of age were predominant in the former case, but the clients more than sixty were predominant in the latter case. 3. The purposes of age correction showed different distribution for ages: job or employment for 20's and 30's, marriage for 20's, registration for school for below six, welfare and other social services for 50 and older. 4. Age was estimated by Nolla's growth stage for 12 and under, calcification of the second and third molar for 12~20, and for 20 and over, Takei's tooth abrasion model was used. 5. The alleged age was in accordance with the documents and other information given by clients, but in the 20.6% of the estimation cases, the alleged age was discarded. In the results of the analysis of age determination cases in Koreans, many of the cases resulted from our historical turbulence and social distinctiveness, causing an increase in the necessity for age correction in each age group. For more accurate determination for each age group, further studies with Koreans must be done continuously.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.405-417
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• 2010

Previous studies have already shown that mouthguard is effective in protecting jaw bone, teeth and oral tissue against sports trauma. However, other than severe trauma, repetitive force, such as disorders like clenching, cause teeth or oral tissue damage. These kinds of disorders usually present pathologic attrition in the posterior teeth, resorption in alveolar bone, loss of teeth and destruction of occlusion. Wearing a mouthguard is believed to be effective in preventing these disorders. But its effect is not examined thoroughly enough. The purpose of this study is to identify whether mouthguard is effective in reducing strain caused by clenching. Mandibular first molars in the normal occlusal relationship without any history of dental treatment were chosen. Biaxial type strain gauge was placed on the buccal surface of the tooth. Having maximum occlusal force, measured by load cell, as a standard, clenching intensity were divided into three stages; moment of slightly tooth contact, medium bite force (50% of maximum bite force), maximum bite force. Strain occurring in dentition in each stage with and without mouthguard was measured. Changes in strain (on dentition) between each stage and difference in strain, between with or without mouthguard were recorded by PCD-300 analyzer and PCD-30 soft ware. The data was statistically analyzed by Wilcoxon signed rank test. The following results were drawn; Without mouthguard, strain given on dentition increased as the clenching force increased. With mouthguard, strain given on dentition also increased as the clenching force increased. With mouthguard, strain decreased, in all cases of clenching force stages. Data on the moment of slightly tooth contact stage, had no statistical significance. However, with mouthguard, 50-90% of decrease in strain could be obtained in maximum occlusal force, compared to the group without mouthguard. Mouthguard decreased the strain on the dentition, caused by clenching. Therefore, mouthguard seems to be effective in preventing damage on dentition, by acting against clenching, which occurs both consciously and unconsciously during sports activities.

• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.1-11
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• 2004

Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

• The korean journal of orthodontics
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• v.26 no.1 s.54
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• pp.53-63
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• 1996

In order In analyze the occlusion of TMD patient, 73 casts and post eroanterior cephalometric X-rays of patients showing TMD symptoms at first interview were measured and compared that of 30 non-patients . Horizental overjet, vertical overbite, openbite, crossbite, depth of curve of Spee, midline deviation, facial asymmetry, attrition, and TPI were measured and processed statistically The results could be summarized as follows, 1. TMD group showed the highest prevalence in twenties, teens, and before 9 years old group in order, and more prevalent in female than male. 2. There were no statistically significance between two groups of overjet and overbite measurements, but showed significance of 6 classification of anterior tooth relationship between two groups TMD groups. 3. n group had more anterior openbite than normal group but there were no statistically significance between two groups. 4. Anterior crossbite was more prevalent in normal group brit posterior crossbite was more prevalent in TMD group. 5. TMD group showed deeper curve of Spee and there were statistically significance between two groups. 6. TMD group had more attrition than normal group and there were statistically significance beween two groups. 7 TMD group showed more facial asymmetry than normal group. 8. TPI did not showed statistical significance beween two groups. According to the above results, TMD group showed severe and complex mode of malocclusion and this should be carefully regarded when treatment planning and during the treatment of malocclusion.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.144-151
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• 2005

Erosion is believed to be the predominant cause of teeth wear in children and young adults, although there will at ways be a contribution from attrition and abrasion. The pH of cola is known to be low and have, therefore, been implicated in the increasing incidence of erosion. The aim of present study was to evaluate the effect of cola on the progression of erosive demineralization in human enamel using demineralization model in vitro. Six groups of human enamel slap were immersed(5 min each bath) in fresh cola, with immersions taking place with or without agitation, and under 3 regimes of frequency intake(low intake, 1 immersion/day; medium, 5/day; high, 10/day). Quantitative assessments of surface erosion were done over an 8-day interval using surface microhardness testing. 1. The average pH of cola was 2.5, which was acidic enough to cause tooth erosion. 2. All the enamel specimen exposed to cola showed erosion like lesions and surface hardness decreased in proportion to the length of immersion (p<0.05). 3. The surface hardness of enamel decreased in proportion to the frequency of immersion (p<0.05). 4. Increased degassing from the drink by gitation accelerated the enamel softening compared with those without agitation.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.285-294
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• 1991

The human temporomandibular joint as a ginglymoarthrodial one has much in common with the other synovial joints of the body, but it does possess an unique charachteristic in that it must accomodate the various occlusal relations of dentition during an end point of closure. For that reason, the movement of the condyle in the temporomandibular joint is susceptible to influences from the nature of occlusion. Undue loading to the temporomandibular joint can be applied on the occasion of premature contacts in centric relation, balancing side interferences, change of occlusal surfaces due to excessive attrition, loss of tooth. Such occlusal disharmonies in association with the systemic and emotional factors may give rise to the temporomandibular disorder. On the other hand, the changes of occlusal patterns in the growing body can also have an effect on the growth of the temporomandibular joint through the alterations of functional stresses. The purpose of this study was to observe histopathologic response of the temporomandibular joint in unilateral chewing on one side exclusively for 10 months. Three dogs showing normal masticatory function were chosen. One dog aged about 12 months was for control, two dogs for experimental specimens were about 12 and 18 months old respectively. For chewing on the left side only, unilateral lower right premolar and molar were extracted in two experimental specimens. And then three dogs were sacrificed 10 months later. Frontal histologic sectioning of joints were done for the observation of the effects of one-side chewing. 24 specimens from three dogs were obtained and fixed in 10% formalin and routinly processed with H-E staining for histologic examination. The light microscopic findings were interpretated as follows: 1. Experimental specimen 1 aged about 22 months: In comparison with control and right non-chewing side, the proliferative and hypertrophic zone were increased at the mesial and lateral part of left chewing side condyle. There was no change of the articular tissue of temporal bone. 2. Experimental specimen 2 aged about 28 months: The articular tissues of adult joint were observed. The differences between the chewing and non-chewing side were not seen in the articular tissues of condyle and temporal bone.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.132-139
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• 2016

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.