• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.487-496
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• 2021

Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.456-466
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• 2019

As digital dentistry technology is being developed, it is being used in various ways. This case covers how digital dentistry technology is being applied on the treatment of patients with loss of vertical dimension due to worn dentition and multiple loss of teeth. The loss of vertical dimension was carefully assessed and recovered, and implants were placed with surgical guides, designed considering the final restoration. The movement of the mandibular was measured with the electronic instrument for recording mandibular movement. Wax-up process was done with Naturgemäße Aufwachs-Technik (N.A.T.) and Natural functional reconstruction (N.F.R.). It was scanned, and the provisional restoration was fabricated using Computer-Aided-Design/Computer-Aided-Manufacturing (CAD/CAM) technology, and the adjustment process was done at the clinic to meet with the satisfaction both functionally and esthetically, and then, using double scanning and CAD/CAM technology, it was carried out as a final restoration. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.382-388
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• 2019

Increased anterior teeth mastication following posterior teeth loss leads to greater anterior occlusal force. It may cause greater attrition of anterior teeth, traumatic force occlusion (TFO), also often followed by antagonist extrusion and occlusal disharmony. This clinical report describes the treatment for a 67-year-old female patient diagnosed with loss of both maxillary and left mandibular posterior teeth, severe attrition of maxillary and mandibular anterior teeth and extrusion of multiple teeth. A diagnostic cast was mounted on articular in centric relation (CR) position to evaluate vertical dimension (VD) and interspace. To provide adequate space for the prosthetic reconstructions, VD was increased by 3 mm on the anterior pin. And then diagnostic wax-up was completed upon that VD. Wax-up was converted to provisional restorations and verified in the patient's mouth and the final restorations were delivered. Clinical follow up examination held 3 months after temporary restoration owing to changes in vertical dimension revealed proper function in mastication without evidence of temporo-mandibular joint (TMJ) disorders. This clinical report presents successfully restoring severe attrition case with increasing vertical dimension resulting in satisfaction in esthetics and function.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.324-329
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• 2012

Excessive tooth wear causes loss of tooth structure, disharmony of occlusal plane, functional and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by growth of alveolar bone, if the length of tooth is not enough for the retention of restoration, minimum increase of occlusal vertical dimension is required without discomfort of the patient. In this case, 33-year-old woman drinks more than 1 liter of soft drinks a day and has bruxism in night time, visited in Seoul National University Dental Hospital with chief complaint of generalized tooth wear and related esthetic and functional problems. It was considered as a loss of occlusal vertical dimension based on the accelerated tooth wear caused by erosion and bruxism and facial appearance, phonetic, esthetic, functional evaluations. It was planned to raise occlusal vertical dimension by provisional restoration two times for patient's adaptation, 3 mm and 2 mm each, total 5 mm. Confirming no discomfort and clinical symptom during total 16 weeks after restoration with provisional fixed restoration, it was restored with porcelain fused to gold crown and bridge. Because the patient was young woman, anterior teeth were restored with collarless porcelain fused to gold crown. This case presents that satisfactory esthetic and functional result by full mouth rehabilitation with increase of occlusal vertical dimension.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 2022

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.234-244
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• 2023

Tooth wear refers to the loss of dental hard tissue caused by various physiological and pathological causes, and excessive pathological wear can cause complications such as pathological changes in dimensions, occlusal disharmony, loss of function, and aesthetic problems. The cause of tooth wear can be caused by attrition, abrasion, corrosion and abfraction, and it is known to act in a multifactorial etiology in interocclusal activity. In patients with excessive pathological wear, it is important to determine whether or not the vertical dimension of occlusion is reduced, and complete oral rehabilitation should be achieved with the adaptation of the neuromuscular and temporomandibular joint through accurate diagnosis and analysis. The patient in this case was a 63-year-old male patient, who presented discomfort to cold beverage due to severe tooth wear. After analysis of the patient's vertical dimension of occlusion, a full mouth rehabilitation was performed with increasing vertical dimension of occlusion. The goal of treatment was to improve the occlusal plane with the equal-intensity contact of all teeth, harmonious anterior guidance and immediate disclusion of all posterior contacts. After rehabilitation, the patient was satisfied with function and esthetic appearance.

• The Journal of Advanced Prosthodontics
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• v.4 no.2
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• pp.109-115
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• 2012

PURPOSE. The purpose of this clinical study was to evaluate the frequency and type of prosthetic complications in relation to type and properties of removable dentures and to investigate the influence of these complications and several data about the existing dentures on patient satisfaction. MATERIALS AND METHODS. Ninety nine patients (44 males and 55 females) wearing removable dentures have been included in the study. The complications of the patients were recorded; patient satisfaction was determined with a Visual Analog Scale (VAS) and the relationship of complications and patient satisfaction with several data about the dentures such as denture age, type of denture, centric relation and vertical dimension was investigated. Kruskal Wallis, Mann Whitney U and Chi square tests were used for statistical analyses. The results were evaluated statistically at a significance level of $P$ <.05. RESULTS. Need for addition of artificial teeth for dentures with correct centric relations was found to be significantly lower than dentures with wrong centric relations ($P$ <.01). Loss of retention, ulcerations and high vertical dimension affected the VAS chewing ability scores negatively and ulcerations affected the VAS phonation scores negatively ($P$ <.05). CONCLUSION. Considering the results of this study, it can be concluded that loss of retention, ulcerations and high vertical dimension caused patient dissatisfaction. Additionally, dentures with wrong centric relations caused need for addition of artificial teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.3
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• pp.227-234
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• 2018

Excessive teeth wear may result in the complications such as esthetic problems, hypersensitivity, and loss of vertical dimension. This clinical report focuses on the causes of severely worn dentition and the full-mouth rehabilitation of a patient with rheumatoid arthritis for 20 years. An interview, clinical and radiological examinations were performed to analyze the causes and decide the treatment plan. After delivery of the final prostheses, a night guard was used to protect the restorations and temporomandibular joints. The patient was satisfied esthetically and functionally.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.91-99
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• 2022

Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient's adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.146-157
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• 2023

The bite collapses due to posterior teeth loss or wear results in inadequate space for restoration and esthetic concerns. Increasing the occlusal vertical dimension to improve space deficiency rotates the mandible posteriorly, creating a gap between the maxillary and mandibular anterior teeth, leading to loss of anterior guidance. To solve this problem, the prosthodontics or orthodontics treatments are the commonly used methods for proper anterior guidance. However, it is reasonable to assume that the anterior teeth can naturally relapse to their original position when the occlusal force is eliminated. Therefore, this case report aimed to test whether natural relapse could recover the lost anterior guidance to develop a less invasive and more convenient treatment method. Digital superimposition was used to evaluate the changes in anterior teeth alignment to confirm the change of the recovered anterior guidance. The appropriate indications for this new treatment method were defined and applied clinically.