J Korean Acad Prosthodont.  2018 Jan;56(1):31-39. 10.4047/jkap.2018.56.1.31.

A case of full mouth rehabilitation in patient with loss of vertical dimension and deep bite due to tooth wear

• Seo SY
• Lee NY
• Kang JK

• KMID: 2402985
• DOI: http://doi.org/10.4047/jkap.2018.56.1.31

Abstract

The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.

Keyword

Deep bite; Partially edentulous patient (partial edentulism); Removable dental prostheses; Full mouth rehabilitation

MeSH Terms

Dental Occlusion
Dental Prosthesis
Diagnosis
Humans
Mouth Rehabilitation*
Mouth*
Overbite*
Prostheses and Implants
Temporomandibular Joint
Tooth Eruption
Tooth Wear*
Tooth*
Vertical Dimension*

Figure

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  Fig. 1 Intraoral photograph before treatment. (A) Upper, (B) Right, (C) Frontal, (D) Left, (E) Lower.

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  Fig. 2 Panoramic radiograph before treatment.

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  Fig. 3 TMJ series before treatment. (A) Rt. close, (B) Rt. opening, (C) Lt. opening, (D) Lt. close.

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  Fig. 4 Facial photographs before treatment. (A) Frontal view, (B) Lateral view.

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  Fig. 5 Diagnostic wax-up model. (A) Right, (B) Frontal, (C) Left.

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  Fig. 6 Vertical dimension of occlusion evaluation.

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  Fig. 7 Provisional restoration. (A) Occlusal view (maxillary), (B) Frontal view, (C) Occlusal view (mandible).

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  Fig. 8 Interocclusal relationship registrations using provisional restorations. (A) Registration of posterior restoration, (B) Registration of anterior restoration.

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  Fig. 9 Full contour wax-up & cut back & coping try in. (A) Full contour wax-up (B) Cut back (C) Coping try in.

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  Fig. 10 Porcelain fused to metal crown try in. (A) Occlusal view (maxilla), (B) Frontal view (C) Occlusal view (mandible).

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  Fig. 11 Maxillary removable partial denture fabrication. (A) Impression taking, (B) Working cast of maxilla, (C) Wax denture.

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  Fig. 12 Definitive prosthesis. (A) Upper, (B) Right, (C) Frontal, (D) Left, (E) Lower, (F) Right working, (G) Protrusive, (H) Left working, (I) Right balancing, (J) Left balancing.

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  Fig. 13 Facial photographs after treatment. (A) Frontal view, (B) Frontal view smile, (C) Lateral view.

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  Fig. 14 Panoramic radiograph after treatment.

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  Fig. 15 TMJ series after treatment. (A) Rt. close, (B) Rt. opening, (C) Lt. opening, (D) Lt. close.

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