선택한 단어 수는 입니다.
최소 단어 이상 선택하여야 합니다.
최소 단어 이상 선택하여야 합니다.
선택한 단어 수는 30입니다.
최대 10 단어까지만 선택 가능합니다.
최대 10 단어까지만 선택 가능합니다.
문제 정의
- There was not enough interocclusal space to restore the missing mandibular molars. As the result, it was decided that full mouth rehabilitation with OVD increment for functional and esthetic restoration. The patient’s freeway space was 5 mm, being greater than the normal value, 2 - 4 mm.
제안 방법
- Based on this, diagnostic wax-up was made to determine occlusal restoration, and a temporary prosthesis was fabricated to evaluate the patient’s adaptation to the increased OVD.
- The reduced OVD was restored and the posterior support was established through full mouth rehabilitation using surveyed crowns, removable partial dentures, and implants. Freeway space, interocclusal space for restoration and facial appearance were carefully evaluated to determine the amount of OVD increment, and OVD was increased by 2 mm through prosthetic rehabilitation. In general, increasing OVD up to 5 mm is considered to be a feasible alteration and whether an alteration of OVD exceeds the capacity of the neuromuscular system should be evaluated through provisional restorations or removable appliances.
- The definitive fixed restorations were PFM surveyed crowns that were designed and fabricated in a digital method. 3D laser scanner (3Shape D800, 3Shape A/S, Copenhagen, Denmark) was used to make digital impressions of mater casts and interocclusal relation.
- Preliminary impression was obtained to make diagnostic casts. The diagnostic casts were mounted on a semi-adjustable articulator (Hanau Modular Articulator, Whip Mix Corp., Louisville, KY, USA) with a face-bow record and a centric relation registration record. There was not enough interocclusal space to restore the missing mandibular molars.
- In general, increasing OVD up to 5 mm is considered to be a feasible alteration and whether an alteration of OVD exceeds the capacity of the neuromuscular system should be evaluated through provisional restorations or removable appliances.11 The patient used the provisional restorations for about 4 months and there were no discomforts, temporomandibular joint disorders, and wears or fractures of the provisional restoration. In the definitive restorations, the anterior guidance was established by fixed restorations on the anterior teeth and uniform occlusal contact of the posterior teeth was achieved in the centric occlusion, preventing recurrence of wears and blocking lateral forces to the posterior implants.
- Thus, definitive restorations were designed to reproduce OVD in provisional restorations. The patient wanted removable partial dentures and implants which are covered by national health insurance for definitive restorations, and did not want complicated surgery such as bone grafting. Therefore, definitive treatment plan was to make removable partial dentures (RPD) with surveyed crowns.
- The patient wanted removable partial dentures and implants which are covered by national health insurance for definitive restorations, and did not want complicated surgery such as bone grafting. Therefore, definitive treatment plan was to make removable partial dentures (RPD) with surveyed crowns. In addition, placement of two implants in the mandibular posterior region was planned to obtain additional retention and support for the mandibular RPD.
- The patient in this case had excessive wear of the mandibular anterior teeth due to loss of mandibular posterior teeth for a long time, moreover the opposing maxillary dentition were porcelain prosthesis. This clinical report describes that a satisfactory clinical result was achieved with an improvement in functions and esthetics by full mouth rehabilitation restoring the OVD using removable partial dentures and few implants.
- The patient was well adapted to the provisional prosthesis with raised OVD and did not show temporomandibular joint discomfort. Thus, definitive restorations were designed to reproduce OVD in provisional restorations. The patient wanted removable partial dentures and implants which are covered by national health insurance for definitive restorations, and did not want complicated surgery such as bone grafting.
대상 데이터
- Paul, MN, USA) for surveyed crowns. The master casts were fabricated with a Type IV dental stone (GC Fujirock EP, GC Europe N. V., Leuven, Belgium). Occlusal rims were fabricated with visible light-curing acrylic resin (Triad TruTray VLC, Dentsply Inc.
- There was no history of para-functional habit or TMJ disease. The patient had a brachycephalic face with slightly developed masseter muscles.
- The patient was a 75-year-old female who was referred from the Department of Periodontics for prosthetic consultation. Her chief complaint was that it was inconvenient to eat because mandibular posterior teeth have been lost for a long time and mandibular anterior teeth were worn out.
성능/효과
- Oral hygiene instruction and regular follow up check were administered. After follow-up checks at one week, one month, six months, and 1 year interval, the result was functionally and esthetically satisfying.
- 17-20 On the other hand, in this case, two single implants were placed on the mandibular posterior molars, and the occlusal rests and the retention arms were designed on the implant surveyed crowns, so it was suspected that functional force will be exerted on the implant during insertion, removal and function. However, the bone quality of implants insertion site was good, and the measured implant stability quotient (ISQ) values were 88 (mandibular left implant) and 86 (mandibular right implant). It is also expected that the implants will have a good prognosis because the occlusal force on the implants will not be large due to the opposing maxillary distal extension RPD and because the implant is protected during lateral & protrusive excursion by canine guidance.
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