• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.39
• /
• pp.13.1-13.8
• /
• 2017

Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

• 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.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.3
• /
• pp.196-207
• /
• 2018

An accurate implant placement with ideal location is significant for long-term success of the implant. An exact evaluation of nearby anatomic structures such as quality of residual bone, an inferior alveolar bone and a maxillary sinus is required. For a prosthetic-driven treatment, planned surgery, precise prosthesis and communication with the patient are significant requisites especially for full-mouth rehabilitation. In this case, the patient with severe alveolar bone resorption had a CT guided surgery supported by CT data and the data from scanning diagnostic wax-up. Afterward, edentulous area was restored by full mouth implant-supported prosthesis by using monolithic zirconia and CAD/CAM technique. This paper reports the outcome of the procedure which was remarkable both esthetically and functionally.

• 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.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.38 no.3
• /
• pp.162-170
• /
• 2022

In the case of patients with pathological tooth wear, it is necessary to evaluate the loss of the vertical dimension. Setting the appropriate vertical dimension is important to rehabilitate the patient's stable intermaxillary relationship. A 77-year-old female patient's chief complaint was the pain of the mandibular incisors and the lack of molars. At the first visit, pathologic tooth wear of the mandibular incisors were observed. After diagnosis and evaluation, loss of vertical dimension was not observed, but insufficient intermaxillary space for prosthetic restoration was confirmed. Mandibular rehabilitation was performed with vertical dimension increase and this showed satisfactory results both functionally and aesthetically.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.1
• /
• pp.45-55
• /
• 2022

PURPOSE. This in vitro study investigates the effect of different post-rinsing times and methods on the trueness and precision of denture base resin manufactured through stereolithography. MATERIALS AND METHODS. Ninety clear photopolymer resin specimens were fabricated and divided into nine groups (n = 10) based on rinsing times and methods. All specimens were rinsed with 99% isopropanol alcohol for 5, 10, and 15 min using three methods-automated, ultrasonic cleaning, and hand washing. The specimens were polymerized for 30 min at 40℃. For trueness, the scanned intaglio surface of each SLA denture base was superimposed on the original standard tessellation language (STL) file using best-fit alignment (n = 10). For precision, the scanned intaglio surface of the STL file in each specimen group was superimposed across each specimen (n = 45). The root mean square error (RMSE) was measured, and the data were analyzed statistically through one-way ANOVA and Tukey test (α < .05). RESULTS. The 10-min automated group exhibited the lowest RMSE. For trueness, this was significantly different from specimens in the 5-min hand-washed group (P < .05). For precision, this was significantly different from those of other groups (P < .05), except for the 15-min automated and 15-min ultrasonic groups. The color map results indicated that the 10-min automated method exhibited the most uniform distribution of the intaglio surface adaptation. CONCLUSION. The optimal postprocessing rinsing times and methods for achieving clear photopolymer resin were found to be the automated method with rinsing times of 10 and 15 min, and the ultrasonic method with a rinsing time of 15 min.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.32 no.1
• /
• pp.23-32
• /
• 2023

A patient with para-functional habits can cause widespread teeth wear, along with temporomandibular joint disorders and myofascial pain syndrome in the masticatory muscles. Prolonged teeth wear is associated with a decrease in vertical occlusal dimension, leading to issues such as changes in facial morphology, decreased masticatory efficiency, and temporomandibular joint disorders. To achieve a three-dimensional full-mouth rehabilitation in patients with decreased vertical occlusal dimension, accurate diagnosis, analysis, and proactive treatment planning are essential. Prosthetic treatment accompanied by the restoration of physiological vertical occlusal dimension and the re-establishment of a normal occlusal plane is necessary. This case report presents a full-mouth rehabilitation case involving a patient with overall teeth wear, showing decreased vertical occlusal dimension which results in discomfort in the temporomandibular joint and aesthetic dissatisfaction. The report highlights the successful outcome achieved through the use of occlusal stabilization splint for temporomandibular joint stability and Gothic arch tracing devices for the re-establishment of intermaxillary relationships. Also, through adjustments and adaptation assessment using provisional prostheses, favorable outcomes were achieved both functionally and aesthetically.

• The Journal of Korean Academy of Prosthodontics
• /
• v.60 no.1
• /
• pp.63-70
• /
• 2022

Teeth wear with loss of posterior support often leads to symptoms such as irregular occlusal plane and excessive wear of anterior teeth. In such environment, establishing proper posterior support and harmonious anterior guidance and occlusal plane is recommended. In this case, the patient had excessively worn dentition with loss of posterior support, while denying surgical treatment due to her(his) history of osteoporosis, ibandronate injection, and risk of medication-related osteonecrosis of the jaw (MRONJ). To recover the vertical space needed for prosthetic restoration, full mouth rehabilitation with vertical dimension increase of remaining teeth was decided. Missing teeth in the posterior area were restored with mandibular removable partial denture. The treatment plan was determined through careful diagnosis, and every step of procedures including tooth preparation, provisional phase with the increased vertical dimension, and definitive prosthetic phase were carried out accordingly. Once the treatment was completed, the patient was satisfied functionally and esthetically. Periodic examination of oral hygiene, occlusal stability was conducted.

• The Journal of Korean Academy of Prosthodontics
• /
• v.51 no.4
• /
• pp.339-346
• /
• 2013

In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly.

• The Journal of Korean Academy of Prosthodontics
• /
• v.53 no.1
• /
• pp.81-85
• /
• 2015

This report describes the prosthetic treatment of a patient with multiple missing teeth. Installation of five fixtures on maxilla with sinus lift and six fixtures on mandible with ramal bone graft were performed. With implant supported all-ceramic with zirconia core using CAD/CAM technology and porcelain-fused-to-gold prosthesis, treatment with positive outcome which satisfies both functional and esthetical aspect was obtained.