• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.3
• /
• pp.243-249
• /
• 2018

Excessive tooth wear results in unacceptable damage to the occlusal surface and can cause pulpitis, occlusal disharmony, dysfunction, and unesthetic result. Patients with severe attrition have to be classified as several types relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. The patient in this case was a 80 - year - old woman who lost support of posterior occlusion and collapsed of the occlusal plane due to confrontation of the opposing teeth, accompanied by an increase in the number of remaining bristles, resulting in a loss of intermaxillary space for prosthesis. In this case, treatment with increased vertical dimension may have stability if the increase in vertical occlusal height is minimized within the required range, and a stable occlusal contact is provided after an increased vertical occlusal height stabilization period. After the new VDO had been confirmed under interim fixed restorations, definitive fixed restorations were produced. Through these treatment processes, we obtain satisfactory results that are functional and aesthetically pleasing.

• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.4
• /
• pp.360-367
• /
• 2018

Extensive dental erosion and wear will cause serious loss of function and aesthetics in the mouth. In order to recover this condition, careful analysis of the patient's bite relationship is required. In particular, a treatment plan should be established considering the possibility of reproduction of the vertical dimension and centric relation, and appropriateness of the occlusal plane and anterior guidance. Also, the choice of prosthetic materials is an important consideration in patients with severe wear. In this case, patients with overall wear and erosion on tooth was established anterior guidance by orthodontic treatment and fully restored with monolithic zirconia, without increasing vertical dimension.

• Restorative Dentistry and Endodontics
• /
• v.43 no.1
• /
• pp.13.1-13.7
• /
• 2018

Dental erosion is frequently overlooked in clinical practice. The management of erosion-induced damage to the dentition is often delayed, such that extensive occlusal rehabilitation is required. These cases can be diagnosed by a careful clinical examination and a thorough review of the patient's medical history and/or lifestyle habits. This case report presents the diagnosis, categorization, and management of a case of gastro-esophageal reflux disease-induced palatal erosion of the maxillary teeth. The early management of such cases is of utmost importance to delay or prevent the progression of damage both to the dentition and to occlusal stability. Non-invasive adhesively bonded restorations aid in achieving this goal.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.32 no.3
• /
• pp.202-208
• /
• 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 and functional disorders. In this case, a patient with severely worn dentition was treated. Diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated with zirconia crown and routine clinical assessments were made. Esthetically and functionally satisfactory results were obtained.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.2
• /
• pp.228-237
• /
• 2021

Physiologic tooth attrition is accepted as a natural change. But when pathologic changes, such as loss of occlusal vertical dimension, masticatory pain, loss of masticatory function, and loss of esthetics occur, restorative measures should be taken by dentist. A patient visited the clinic with the chief complaint of 'My lower teeth bite the palate and it hurts'. It was diagnosed as iatrogenic attrition of lower natural dentition caused by inappropriate upper restorations, resulting in traumatic overbite. Through model analysis and diagnostic wax up, increase in vertical dimension was decided. Upper and lower dentitions were restored with new prostheses. After restoration, satisfactory outcomes were achieved both in functional and esthetic aspects.

• The Journal of Korean Academy of Prosthodontics
• /
• v.53 no.1
• /
• pp.26-38
• /
• 2015

Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.2
• /
• pp.160-166
• /
• 2016

Although physiologic abrasion in normal range need not to be corrected, when hard tissue of teeth are worn abnormally fast, it can cause severe damage and destroy esthetics and, functional structure of occlusion consequently. To establish a correct occlusal plane and space for the patient with worn dentition, it is necessary to increase vertical dimension. However, actual occlusal vertical dimension remains unhanged with compensation for the increase of alveolar bone height equivalent to the decrease of teeth length. A 74-year-old male presented with worn dentition and fractured tooth. Based on the assessment of OVD including clinical findings, full-mouth rehabilitation without increase of OVD was planned. This case presents that a satisfactory clinical result was achieved by restoring the worn dentition without changing occlusal vertical dimension.

• The Journal of Korean Academy of Prosthodontics
• /
• v.50 no.4
• /
• pp.305-310
• /
• 2012

It is a great challenge for dentists to do prosthetic restorations of a patient with reduced occlusal vertical dimension (OVD). Proper determination of the OVD is significant. An 85-year-old male patient came in with missing right maxillary posterior teeth. After diagnostic wax-up, reversible provisional prostheses were used to evaluate the new OVD in the maxilla and mandible. After that, the patient was evaluated clinically based on the criteria of esthetic, phonetic, and OVD. After 8 weeks, teeth with excessive wear were treated with root canal therapy and fiber post and core and irreversible provisional prostheses were done. After 8 weeks of observation period, final restorations with fixed partial dentures and removable partial dentures were made. Throughout the follow-up period of 6 months, no symptoms related with increased OVD and mechanical complications were observed.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.1
• /
• pp.134-143
• /
• 1998

Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

• Journal of Technologic Dentistry
• /
• v.42 no.4
• /
• pp.348-354
• /
• 2020

Purpose: Zirconia is differentiated from other ceramics because of its high resistance to corrosion and wear, excellent flexural strength (900~1400 MPa), and high hardness. Dental zirconia with proven mechanical/biological stability is suitable for the manufacture of implants. However, there are limited in vivo studies evaluating stress distribution in zirconia compared with that in titanium implants and studies analyzing finite elements. This study was conducted to evaluate the stress distribution of the supporting bone surrounding zirconia and titanium implants using the finite element analysis method. Methods: For finite element analysis, a single implant-supported restoration was designed. Using a universal analysis program, eight occlusal points were set in the direction of the occlusal long axis. The occlusal load was simulated at 700 N. Results: The zirconia implant (47.7 MPa) von Mises stress decreased by 5.3% in the upper cortical bone compared with the titanium implant (50.2 MPa) von Mises stress. Similarly, the zirconia implant (20.8 MPa) von Mises stress decreased by almost 4% in the cancellous bone compared with the titanium implant (21.7 MPa) von Mises stress. The principal stress in the cortical and cancellous bone exhibited a similar propensity to von Mises stress. Conclusion: In the supporting bone, the zirconia implant is able to reduce bone resorption caused by mechanically transferred stress. It is believed that the zirconia implant can be a potential substitute for the titanium implant by reinforcing aesthetic characteristics and improving stress distribution.