• Journal of Dental Rehabilitation and Applied Science
• /
• v.19 no.3
• /
• pp.247-256
• /
• 2003

The patient had bruxism and epilepsy tendency. Inadequate or unstable posterior support was identified due to severe anterior attrition and decreased occlusal vertical dimension. Prematurities of posterior occlusal and wear facets increased the function of anterior teeth, resulting in severe wear. Wear facets displayed sharply defined peripheries, which are matched on articulated diagnostic casts. Also the patient showed C III malocclusion tendency, and lost some facial contour with drooping corners on the mouth. In this case, the alteration of OVD (Occlusal Vertical Dimention) may provide a biologically compatible adjunct to the treatment such as dentofacial esthetics, improved visual proportion in facial heightand mechanical solutions to the force-management of the masticatory system. The patient requires extensive restorative treatment to regain appropriate function, esthetics and comfort. According to the report by Farhad Fays, the average vertical distance from the maxillary to the mandibular mucolabial reflection in the region of the central incisors is approximately 34mm. However, the vertical distance of this patient was found to be 32mm, which was necessary to add gauge 20-sheets to apply vertical dimension. A removable occlusal overlay splint, which restores OVD to the estimated optimalposition, is the general first trial. The patient was observed periodically for 6 weeks, while appropriate adjustments were made vertical dimension to function. When patient felt comfortable with the splint, the teeth were prepared, and provisional restorations are placed for 3 months. The provisional restoration was fabricated by a diagnostic wax-up. When the patient felt comfortable with the provisional restoration, the final restoration mimics OVD, function, and esthetics that have been developed in the treatment restorations. Restoration of the extremely worn dentition presents a substantial challenge to thedentists. Therefore, careful evaluation of the etiology, history, and factors associated with occlusal vertical dimension should be preceded prior to the appropriate treatment planning.

• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.1
• /
• pp.70-76
• /
• 2018

Excessive tooth wear can lead to decrease in occlusal vertical dimension and can cause pathological changes in the oral environment and masticatory system. When recovering occlusal vertical dimension and occlusion, accurate diagnosis and analysis are essential. This clinical case describes a 75-year-old woman with severely worn dentition due to loss of the posterior support. Full mouth rehabilitation with occlusal vertical dimension increment was planned. Clinical and radiographic examinations, occlusal vertical dimension evaluation, and diagnostic wax-up were performed and patient adaptability was evaluated using provisional restorations. As for definitive restoration, considering economic condition of the patient, removable partial denture was fabricated and solitary implants were placed in the mandibular left and right posterior region to increase support and retention of the removable partial denture. During one year of follow-up, functional and esthetic outcomes were observed satisfactory.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.2
• /
• pp.121-129
• /
• 2020

From the point of view of oral rehabilitation, the treatment of extensive tooth wear requires a prosthetic approach. Physiological tooth wear is considered as a normal process and generally does not require treatment, but excessive tooth wear causes problems like inadequate occlusion and esthetics. Changes of occlusal vertical dimension should be made through accurate diagnosis and analysis. Also, the patient's adaptation to the changed occlusal vertical dimension should be assessed over time. This case was a 60-year-old male patient who complained of a decrease in chewing function and esthetics due to severe tooth wear. Full-mouth rehabilitation was performed with a tooth supported fixed prosthesis. An occlusal stabilization splint and provisional restoration were used to evaluate the adaptation to increased occlusal vertical dimension and induce a stable centric relation position. After that, monolithic zirconia prosthesis was delivered. We report this as a satisfactory functional recovery and esthetics.

• The Journal of Korean Academy of Prosthodontics
• /
• v.55 no.1
• /
• pp.38-45
• /
• 2017

In removable partial denture with crossed occlusion, it is difficult to meet the satisfaction of patient due to variable movement of denture and unfavorable stability under loading. In a case with few unilaterally teeth remaining, additional treatments such as implantation or residual root are required to assure bilaterally stable support. However, due to the medical condition of the patient with hypertension, angina and old age etc., removable partial denture was planned as treatment in this case. Proper diagnosis, accurate analysis and full understanding of the adaptation for neuromuscular system are necessary to recover the vertical dimension of patient from a decreased vertical dimension due to crossed occlusion.

• The Journal of the Korean dental association
• /
• v.53 no.9
• /
• pp.602-609
• /
• 2015

The aim of this document is to evaluate the effect of bite balance on physical fitness and motor capacity to determine the importance of the occlusal stability as a possible action mechanism of occlusal appliance including mouthguards on physical performances. We all remember that day when the prominent athlete was in the news wearing a mouthguard to improve human athletic performance. I once had investigated the determinants of athletic performance in all sorts of sports. Most of the studies had overinterpretation of results and lack of evidence to support the information. However, I discovered great expectations for new possibility in this field and settled for a more academic approach to this intriguing subject. The followings are some examples of the subject 1. Archers who wore occlusal appliances to increase the vertical dimension of occlusion by 2~3mm increased their ability to focus and to maintain good sense of balance. Their accuracy rate has been improved. The appliance was made of acrylic resin (a type of plastic). 2. Canoe players who wore occlusal appliances to increase the vertical dimension of occlusion by 5mm surpassed longtime competitor and won the race with 10 seconds gap. 3. A cycle rider who wore an occlusal appliance to treat his malocclusion surpassed his old record from 10.8 seconds to 10.3 seconds. His muscle reflexes (anaerobic exercise) and endurance (aerobic exercise) has been enhanced. 4. Occlusal appliances had a good effect on athletic performance in most sports such as swimming, diving, and weightlifting. As for the clenching on dentition, people clench their teeth when they push their physical and mental limits during sports activities. Clenching can be induced by physical exertion when maximum muscle strength is retained and this is similarly found in different types of exercises. In addition, restraint of respiratory function is observed. Therefore, creating a occlusal balance with occlusal appliance or mouthguard promoted a favorable influence when an athlete clenches.

• The Journal of Korean Academy of Prosthodontics
• /
• v.55 no.1
• /
• pp.46-52
• /
• 2017

Provisional restoration plays an important role in the process of restoration with fixed partial denture by providing protection and restoring function and esthetics of abutment tooth. This is especially true in patients requiring use of provisional prosthesis for a long term. However, such situations may lead to higher possibility of provisional prosthesis fracture, and if expected so, reinforcement of provisional prosthesis should be considered. In this article, a patient requiring prosthetic treatment with increase of vertical dimension of occlusion was introduced. Due to increased vertical dimension of occlusion, the provisional restoration was expected to withstand relatively larger amount of load during a relatively long observation period. In order to minimize possible occurrence of fracture, reinforcement of the provisional restoration was sought by insertion of cast-metal framework and by using bis-acryl resin. The reinforced provisional restoration showed satisfactory results during the observation period of 4 months.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.2
• /
• pp.110-120
• /
• 2020

Although not all kinds of deep bite occlusions are considered pathological states, they can cause persistent wear and eruption of the anterior mandibular teeth if the anterior occlusal contact is unstable or accompanied by an occlusal disharmony. The patient was a 72-year-old man with no occlusal contact of the remaining anterior teeth in the centric relation position because of a skeletal class II malocclusion and loss of occlusal support. If the vertical dimension needs to be increased for prosthetic restoration in a patient with a deep bite, the amount of vertical dimension increase must be determined through precise diagnosis. This is because the overjet may increase and cause an unstable occlusion. In this review, we report the case of a patient with a stable occlusion and good treatment results achieved by using a removable partial denture prosthesis and applying the Dahl concept.

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.1
• /
• pp.67-76
• /
• 2020

With the evolution of the computer-aided design/computer-aided manufacturing (CAD/CAM) technology, the intraoral scanners are playing an increasingly important role, as they are the first step towards a completely digital workflow. The CAD/CAM double scanning technique has been used to transfer the information from provisional restorations to definitive restorations. In this case, a 67-year-old male with esthetically compromised anterior teeth, generalized severe attrition of teeth, and reduced vertical dimension was treated with full mouth rehabilitation including a re-establishment of the lost vertical dimension of occlusion assisted by the crown lengthening procedure. The provisional restorations were fabricated using an intraoral scanner and the CAD/CAM double scanning technique. After the period of adaption, the definitive monolithic zirconia restorations were delivered. The CAD/CAM double scanning technique successfully transferred the occlusal and morphological characteristics, obtained from the provisional restorations, to the definitive restorations.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.4
• /
• pp.463-476
• /
• 2010

Inadequate or unstable posterior support cause extrusion of antagonistic teeth and overloading of remaining teeth. Extrusion of antagonistic teeth result in collapsed occlusal plane and decreased prosthetic space. Also, overloading of remaining teeth increase occlusal wear or anterior extrusion of anterior teeth, which is resulting in loss of anterior guidance, disharmony of occlusion and decreased prosthetic space. In this case, careful evaluation of OVD(occlusal vertical dimension) is the general first trial to regain appropriate function and esthetics. Simultaneously, adequate anterior guidance and harmonious occlusal plane should be established in the repeatable reference position of the mandible. We report this case because severely worn dentition achieved functional and esthetic results from full mouth rehabilitation with increased vertical dimension and use of centric relation.

• The Journal of Korean Academy of Prosthodontics
• /
• v.62 no.2
• /
• pp.113-122
• /
• 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.