• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.3
• /
• pp.180-185
• /
• 2012

Purpose: An accurate preoperative analysis of the patient is essential in orthognathic surgery in order to acquire superior results. In profile, the location of the chin's position may change according to the neck's inclination. This may ultimately affect the amount of surgical movement. During acquisition of cephalometric radiographs, or in supine position, there is a discrepancy in the neck's inclination. This means that there are also various discrepancies between the actual profile and the various preoperative profile images. In the clinical situation, the decision in performing genioplasty usually lies in the analysis of the patient's profile on the operating table at the final stages of orthognathic surgery. This study aims to analyze the different preoperative profile images and to compare their discrepancies. Methods: Fifty eight patients undergoing orthognathic surgery were chosen. These patients were divided into three groups according to angle's classification of malocclusion, as class I, II or III. The right profile of these patients in centric occlusion was taken in natural head position (NHP). This was set as the 'actual profile image.' Another right profile image was taken on the operating table after insertion of the nasotracheal intubation and with muscle relaxants in effect. This was also taken in centric occlusion. The angle (denoted 'A') between the soft tissue glabella-pognion and the true vertical plane was found in the above-mentioned profile images and in the cephalometric radiographs. The differences of these values were analyzed. Results: There were differences in Angle 'A' in all of the preoperative images. These values were however, not statistically significant. Conclusion: In order to gain an esthetic profile during orthognathic surgery, the NHP is shown to be the most reliable position. Images reproducing such head positions should be used in the treatment planning process.

• The Journal of Korean Academy of Prosthodontics
• /
• v.27 no.2
• /
• pp.143-154
• /
• 1989

The purpose of this study was to investigate the mandibular opening and closing movements at mandibular incisor region and clinical rest position in normal subject using the newly developed electric mandibular movement analyzing device, (M.K.G.-K6 diagnostic system, Myo-tronics Inc. Seattle, WA, U.S.A.) The 58 normal subjects, who were students of the College of Dentistry, Chonbuk National University, were selected according to sampling criteria. The obtained results were as follows: 1. There was no significant difference of distribution of opening and closing movement patterns at mandibular incisor region between male and female. There was significant difference between habitual and maximum movement patterns both in sagittal and frontal plane. 2. Although the percentage of distribution of crossover pattern was highest in all cases, but there were significant differences between patterns only at habitual opening and closing movement in sagittal plane. 3. The mean of maximum opening was $47.29{\pm}4.68mm$ in male and $42.15{\pm}4.95mm$ in female. Therefore the mean of maximum opening was larger in male than in female. 4. The mean of maximum laterotrusion in frontal trajectory was larger to the left than to the right. Also the proportion of left deviation at maximum opening position was larger than that of other cases. 5. The mean of maximum opening and closing velocity was higher in male than in female and the mean of closing velocity was higher than that of opening velocity. Also the amount of separation from the centric occlusion was higher in maximum closing velocity than in maximum opening velocity. 6. Clinical rest position was $1.70{\pm}0.99mm$ inferior, $0.74{\pm}0.57mm$ anterior, $0.99{\pm}0.51mm$ right from centric occlusion and the A/V ratio was 1:2.7.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.30 no.4
• /
• pp.315-323
• /
• 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.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.2
• /
• pp.195-201
• /
• 2022

Hemimandibulectomy and free fibular flap (FFF) in patients with squamous cell carcinoma could disturb the functional movement of the mandible. The muscular function in the sectioned side was compromised because of the incompetency of the muscle attachment to the mandible, leading to the unstable occlusal contact in the centric and eccentric occlusion. In this report, we present a case of a 63-year-old male who underwent cancer surgery and reconstruction with fibular graft, and he needed a fixed dental prosthesis to restore tooth loss in the anterior region. Occlusal contact change and instability were found according to the bite force in the centric relation and eccentric movement. This case report aimed to present the prosthetic procedure for fabricating the functionally optimized fixed prosthesis wherein the functionally generated path (FGP) technique and digital imaging method were applied to replicate mandibular movement and vertical dimension of the patient.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.1
• /
• pp.110-118
• /
• 2022

Multiple tooth loss can cause disharmonious occlusial plane, loss of vertical dimension and deflection of mandibular movement. Therefore, restoring proper vertical dimension and occlusion in the centric relation is an important treatment goal. Implant-assisted removable partial denture is a recently used clinical technique, because it increases patient satisfaction by improving retention, support, and stability of conventional denture. The objective of this article is to present a case report describing the fabrication of treatment denture and implant assisted removable partial denture using previously placed implants for a patient with partial loss of posterior support and anterior stop.

• The korean journal of orthodontics
• /
• v.30 no.4 s.81
• /
• pp.491-507
• /
• 2000

The purpose of this study was to investigate if there were a significant differences in mandibular position between cephalometric measurements from a centric occlusion tracing compared to those of a acquired centric relation by stabilization splint on malocclusion patient with TMD. 60 malocclusion patients, who had TMD and CO-CR discrepancy beyond normal range, were selected and subdivided into Class I, II, III by Angle's classification and also subdivided into clockwise, straight downward, and counterclockwise group by Jarabak's posterior facial height/anterior facial height ratio. Lateral cephaolmetric radiographs with the mandible in centric occlusion were taken and measured, and for each Patient the stabilization splint with mutually protected occlusal scheme was applied for minimum 3months. After each patient's CO-CR discrepancy was in normal range, lateral cephalometric radiographs were retaken and measured. The comparison of the difference between CO-CR cephalometric measurements in all sample, Class I, II, III groups, and Clockwise, Straight downward, Counterclockwise groups were studied. The finding of this study can be summarized as follows: 1 In all sample, the value of cephalometric measurements was significantly different between CO-CR. The mandible rotated to down and posterior position and the vertical change was greater than the horizontal change (overjet-1.3mm increase, overbite-1.9mm decrease). 2. In Class II malocclusion group, most of the mean difference value between CO-CR is higher than that of the other groups and more measurements was statically significant. 3. In clockwise and counterclockwise group, some of the mean difference value is higher than that of straight downward group and more measurements was statically significant. 4. There ware no measurements that explain centric relation measurements from the type of malocclusion, facial pattern and centric occlusion measurements. Henceforth, it is strongly recommended that stabilization splint therapy for orthodontic treatment on TMD patient should be excuted upon overall facial types prior to orthodontic diagnosis and treatment planning.

• Journal of Oral Medicine and Pain
• /
• v.24 no.1
• /
• pp.49-58
• /
• 1999

저자는 하악의 위치변화가 저작근에 미치는 영향을 근전도학적으로 평가하고자, 측두하악장애의 징후와 증상이 없는 정상성인 28명을 대상으로 중심위 교합장치(centric relation splint), 중심교합위 교합장치(centric occlusion splint), 전방 재위치 교합장치(anterior repositioning splint)를 장착시킨 상태에서 하악의 중심의, 중심교합위, 전방위률 유도한 후 최대 이악물기 상태의 좌우측 교근 및 전측두근의 근전도를 채득, 분석, 평가한 결과 다음과 같은 결론을 얻었다. 1. 전측두근에서 하악의 위치변화에 따른 최대 근활성도의 차이가 나타났으나(p<0.05), 교근에서는 나타나지 않았다. 2. 전측두근의 경우 중심교합위에서 최대 이악물기 상태의 최대 근활성도는 교합 장치물을 장착하지 않은 경우 및 중심위에서와 비교하여 감소하였다(p<0.05). 3. 전측두근의 경우 전방위에서 최대 이악물기 상태의 최대 근활성도는 교합 장치물을 장착하지 않은 경우 및 중심위에서와 비교하여 감소하였다(p<0.001). 4. 교근과 전측두근의 좌우 비대칭지수(asymmetry index)는 하악의 위치변화에 따른 차이가 나타나지 않았다.

• 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.

• The Journal of Korean Academy of Prosthodontics
• /
• v.62 no.3
• /
• pp.201-214
• /
• 2024

In patients with unstable mandibular movements who are accompanied by involuntary facial muscle movements and asymmetrical changes in the facial features, many difficulties exist in determining the vertical dimension of occlusion, recording centric relation, and transferring information about the occlusal plane. In this case, for a patient with unilateral facial nerve palsy who was edentulous for a long period of time, a CAD-CAM provisional prosthesis was fabricated using a 3D printing customized gothic arch tracer and a prefabricated occlusal plane recorder, the POP bow system, to achieve a stable interarch relationship. Afterwards, a full mouth implant fixed prosthesis was fabricated by delivering an appropriate vertical dimension of occlusion, a reproducible centric relation, and a correct three-dimensional occlusal plane, and continuous maintenance was performed to restore functional and aesthetic oral health to the patient.

• The Journal of Korean Academy of Prosthodontics
• /
• v.26 no.1
• /
• pp.171-184
• /
• 1988

The establishment of an optimal and functional condylar position (centric relation) as the therapeutic and diagnostic reference position during occlusal treatment for patients with temporomandibular joint and muscle pain. dysfunction has long been an important subject in dentistry. The objective of this study was to compare the reproducibility md the changes of condylar position in normal group to those in patient group after use of the occlusal biteplane splint. For this study, 11 normal adults who had no symptoms of masticatory dysfunction and 18 patients who had visited at the department of occlusion in dental infirmary of Yonsei University were selected. For each subject three centric relation records were recorded before treatment, after 2 weeks and after symptoms were improved. And the condylar positions in centric relation were measured using articulators and a Vericheck. On the basis of this study, the following results were obtained. 1. In normal group, there was no significant difference of reproducibility in condylar position before and after the use of the occlusal biteplane splint for 2 weeks. 2. In patient group there was significant improvement in the reproducibility of condylar position after treatment (P<0.01). The reproducibility in patient group, however, was less than normal group. (P<0.01) 3. The mean distance of condylar movements was $0.38{\pm}0.22mm$ after 2 weeks in normal group. 4. In patient group, condylar movements were $1.36{\pm}0.70mm$ (P<0.01), significantly different from normal group. (P<0.01) 5. In patient group, the main direction of condylar movements after treatment was toward anterior and superior, preponderance being at superior direction.