• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.2
• /
• pp.145-156
• /
• 2010

Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

• The Journal of Advanced Prosthodontics
• /
• v.11 no.3
• /
• pp.162-168
• /
• 2019

PURPOSE. The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing artificial enamel. MATERIALS AND METHODS. Twenty-five Y-TZP slabs from each brand (Lava, 3M and Bruxzir, Glidewell Laboratories) with different surface conditions (Control polished - CPZ; Polished/ground - GRZ; Polished/ground/repolished - RPZ; Glazed - GZ; Porcelain-veneered - PVZ; n=5) were abraded (500,000 cycles, 80 N) against artificial enamel (6 mm diameter steatite). Y-TZP roughness (in ${\mu}m$) before and after chewing simulation (CS) and antagonist steatite volume loss (in $mm^3$) were evaluated using a contact surface profilometer. Y-TZP roughness was analyzed by three-way analysis of variance (ANOVA) and steatite wear by two-way ANOVA and Tukey Honest Difference (HSD) (P=.05). RESULTS. There was no effect of Y-TZP brand on surface roughness (P=.216) and steatite loss (P=.064). A significant interaction effect (P<.001) between surface condition and CS on Y-TZP roughness was observed. GZ specimens showed higher roughness after CS (before CS - $3.7{\pm}1.8{\mu}m$; after CS - $13.54{\pm}3.11{\mu}m$), with partial removal of the glaze layer. Indenters abraded against CPZ ($0.09{\pm}0.03mm^3$) were worn more than those abraded against PVZ ($0.02{\pm}0.01mm^3$) and GZ ($0.02{\pm}0.01mm^3$). Higher wear caused by direct abrasion against zirconia was confirmed by SEM. CONCLUSION. Polishing with an intraoral polishing system did not reduce the roughness of zirconia. Wear of the opposing artificial enamel was affected by the material on the surface rather than the finishing technique applied, indicating that polished zirconia is more deleterious to artificial enamel than are glazed and porcelain-veneered restorations.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.29 no.4
• /
• pp.586-591
• /
• 2002

Bruxism can be generally regarded as a diurnal clenching or nocturnal teeth grinding or a combination of both. Clenching of the teeth is forceful closure of the opposing dentition in a static relationship of the mandible to the maxilla, whereas grinding of the dentition is forceful closure of the opposing dentition in a dynamic maxillo-mandibular relationship as the mandibular arch moves through various excursive positions. The causes of bruxism are not yet discovered clearly, but most consistently mentioned cause is psychological stress. Bruxism can be also associated with sleep disorders, medication, and disturbances of the central nervous system. There is no permanent treatment method of bruxism, so the objectives for management of bruxism are reduction of psychological stress and treatment of signs and symptoms of bruxism by occlusal adjustment, occlusal splint, systemic medication and physical therapy. These cases report present three cases of children with bruxism. The bruxism was reduced in these patients wearing occlusal splint.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.30 no.2
• /
• pp.71-90
• /
• 2021

The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.17 no.3
• /
• pp.189-193
• /
• 2001

교합조정은 비가역적인 술식이므로 예방적인 목적으로 사용하는 것은 바람직하지 않으며 환자가 증상을 호소하거나 환자의 구강검사시 교합간섭으로 인한 증상이 확인된 경우라도 자연치에서의 교합조정술은 반드시 신중을 기해야 한다. 교합조정술을 시행하기 전에 먼저 하악의 위치가 안정되어야 한다는 것을 명심하고 이를 위해 치과의사는 하악의 중심위에 대한 이해와 중심위로의 하악유도 방법에 대한 숙지도 필요하다. 또한 심한 악관절 장애나 통증 및 불안정한 하악의 위치를 보이는 경우 구강내 교합상이나 교합 안정장치가 선행되어야 하는 경우가 있다. 교합조정술을 시행해야 하는 치과의사 자신이 교합조정술에 대한 지식을 충분히 습득하고 있어야 하며, 교합조정술의 적응증을 분명하게 확인한 뒤 조심스럽고 정확하게 시술을 시행해야 한다. 즉, 잘못된 교합조정으로 오히려 교합간섭을 야기할 수도 있음을 명심해야 한다. 그러나 교합조정에 대해 올바로 이해하고 일반적인 교합조정의 원칙을 지켜 정확히 시행한다면 교합조정은 결코 환자에게 해를 주지 않고, 자유로운 하악운동을 가능케 하며, 교합의 안정성을 유지해 줄 것이다.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.13 no.2
• /
• pp.13-24
• /
• 2004

In everyday dental practice, one of the most important procedures is fixed prosthodontics which includes gold and ceramic restorative treatments. This procedure can be divided into tooth preparation, impression taking, laboratory work, occlusal adjustment and cementation. The first step is tooth preparation and it needs not only good techniques but also deep knowledge and understanding of oral biology. Also, there must be good knowledge of the principles and materials of the procedure. The patient's satisfaction can be achieved from natural contour, good shade, and precise margin fit, especially in ceramic restorations on anterior regions. It is essential to fastidiously prepare the tooth to make aesthetic restorations with a good margin fit. Tooth preparation techniques and three case reports of ceramic restorations on the anterior region are presented and discussed in this paper.

• The Journal of the Korean dental association
• /
• v.50 no.5
• /
• pp.244-255
• /
• 2012

Temporomandibular disorder(TMD) is described as a cluster of disorders characterized by pain in the preauricular area and/or the muscles of mastication; limitations or deviations in mandibular range of motion; and noises in the TMJ during mandibular function. The most common symptom in TMD patients is pain that is aggravated by chewing or other jaw function. These symptoms are appeared when the stimuli loaded in TMJ are over the physiologic tolerance. The primary goal in treatment of TMD is to alleviate pain and lor mandibular dysfunction. TMD treatment can be divided into 2 categories: reversible and irreversible methods. Reversible methods include medication, thermal therapy, habit modification, physical therapy, appliance therpy and arthrocentesis and lavage and irreversible methods include arthroscopic lysis, surgery, occlusal adjustment et al. It is widely accepted that reversible methods are ther first choice of treatments. However if reversible ones are not effective, irreversible methods are considered.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.4
• /
• pp.423-436
• /
• 2011

Trauma from occlusion (TFO) is a pathologic alterations which develop in the periodontium as a result of undue masticatory force. The purpose of this article is to review the controversies about TFO. There are evidences that TFO is a risk factor in the progression of periodontitis. Tooth mobility should be reduced by selective occlusal adjustment. TFO can be developed dependent on the masticatory pattern, occlusion and anterior overbite in sound periodontal conditions. Secondary TFO may aggravate unstable occlusion. If "loss of posterior support" was occur, the problems were worsen. Extrusion, migration, rotation and pathologic deviation can be resulted. Opposite contention is the "shortened dental arch" concept. However, these two concepts persue the occlusal stability together. To treat TFO adequately, exact diagnosis and multi-disciplinary treatment should be needed.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.357-366
• /
• 2008

Posterior cross-bite is a relatively frequent malocclusion in primary and early mixed dentition and the reported prevalence of posterior cross-bite varies from 7% to 23%. It has been defined as a transverse discrepancy in arch relationship which the palatal cusp of the upper posterior teeth do not occlude in the central fossa of the opposing lower teeth, and can be manifested in a single tooth or in a group of teeth. Posterior cross-bite does not often self-correct and therefore immediate treatment is recommended. Occlusal adjustment to eliminate premature contact that causes mandibular deviation, expansion of narrow maxillary arch, arrangement of the individual teeth to treat asymmetry within the dental arch are the methods of treating cross-bite. In the present case, functional posterior cross-bite was observed in the primary and the early mixed dentition children. The children were treated by the slow maxillary expansion and occlusal adjustment. The outcome of periodic examinations after the correction of cross-bite was favorable.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.204-213
• /
• 2023

Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.