J Korean Acad Prosthodont.  2020 Jan;58(1):35-41. 10.4047/jkap.2020.58.1.35.

Full mouth rehabilitation using removable prosthesis of patient with unstable mandible movements: A case report

• Sohn DH
• Yi YJ
• Jo DW

• KMID: 2469919
• DOI: http://doi.org/10.4047/jkap.2020.58.1.35

Abstract

Patients with collapsed occlusal support and unilateral chewing show parafunctional mandibular movements, which can be complicated in older patients. Gothic arch tracing and split cast technique are used to confirm the deviation between centric relation and anterior habitual bite in patient who has oral dyskinesia and collapsed occlusion. Temporary denture as occlusal stabilization appliance was provided for stable occlusion and reproducible mandibular movement. Definitive denture was fabricated by lingualized occlusion concept.

Keyword

Gothic arch tracing; Lingualized occlusion; Oral dyskinesia

MeSH Terms

Centric Relation
Dentures
Humans
Mandible*
Mastication
Mouth Rehabilitation*
Mouth*
Movement Disorders
Prostheses and Implants*

Figure

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  Fig. 1 (A) Initial panoramic radiograph, (B) Intraoral photo.

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  Fig. 2 Involuntary mandibular movement.

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  Fig. 3 Registration of centric relation using gothic arch tracer at three different VD (vertical dimension). (A) VD = 78 mm, (B) VD = 75 mm, (C) VD = 72 mm.

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  Fig. 4 Gothic arch tracing at three different VD (vertical dimension). (A) VD = 78 mm, (B) VD = 75 mm, (C) VD = 72 mm.

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  Fig. 5 (A) Confirm the centric relation position, (B) Recording the jaw relation with silicone material.

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  Fig. 6 (A) Frontal view of mounted master casts, (B) Double base fabrication after CR position using gothic arch tracing, (C) Confirm the 2 mm deviation between CR and habitual bite.

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  Fig. 7 (A) Intraoral photo with temporary denture, (B) Maxillary temporary denture, (C) Mandibular temporary denture, (D) Indentation marks at central occlusion, (E) Indentation marks during excursive movements, (F) Indentation marks during anterior movements.

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  Fig. 8 Wax denture. (A) Lateral view (right), (B) Frontal view, (C) Lateral view (left).

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  Fig. 9 Definitive denture placement and check the bite, (A) Working side (Right), (B) Maxillary denture, (C) Working side (Left), (D) Right side, (E) Frontal view, (F) Left side, (G) Balancing side (Right), (H) Mandibular denture, (I) Balancing side (Left).

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  Fig. 10 Post-treatment panoramic radiograph.

Reference

1. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent. 1984; 52:467–474.

2. Rivera-Morales WC, Mohl ND. Relationship of occlusal vertical dimension to the health of the masticatory system. J Prosthet Dent. 1991; 65:547–553.

3. Blanchet PJ, Rompré PH, Lavigne GJ, Lamarche C. Oral dyskinesia: a clinical overview. Int J Prosthodont. 2005; 18:10–19.

4. Viswanath A, Gordon SM. Two cases of oromandibular dystonia referred as temporomandibular joint disorder. Grand Rounds. 2012; 12:1–5.

5. Dawson PE. Centric relation. Its effect on occluso-muscle harmony. Dent Clin North Am. 1979; 23:169–180.

6. Kantor ME, Silverman SI, Garfinkel L. Centric-relation recording techniques-a comparative investigation. J Prosthet Dent. 1972; 28:593–600.

7. Wojdyla SM, Wiederhold DM. Using intraoral Gothic arch tracing to balance full dentures and determine centric relation and occlusal vertical dimension. Dent Today. 2005; 24:74–77.

8. Parker HM. Effective management of laboratory procedures and use of split-cast technique. J Prosthet Dent. 1974; 31:325–342.

9. Scandrett FR, Hanson JG. Technique for attaching the master cast to its split mounting index. J Prosthet Dent. 1978; 40:467–469.

10. Michelotti A, Silva R, Paduano S, Cimino R, Farella M. Oromandibular dystonia and hormonal factors: twelve years follow-up of a case report. J Oral Rehabil. 2009; 36:916–921.

11. Scott BL. Evaluation and treatment of dystonia. South Med J. 2000; 93:746–751.

12. Balasubramaniam R, Ram S. Orofacial movement disorders. Oral Maxillofac Surg Clin North Am. 2008; 20:273–285.

13. Goldman JG, Comella CL. Treatment of dystonia. Clin Neuropharmacol. 2003; 26:102–108.

14. Clark GT, Stiles A, Lockerman LZ, Gross SG. A critical review of the use of botulinum toxin in orofacial pain disorders. Dent Clin North Am. 2007; 51:245–261.

15. Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc. 2000; 131:211–216.

16. Ryu JW, Yoon CL, Cho YG, Ahn JM. Clinical manifestations in orofacial movement disorders. J Oral Med Pain. 2008; 33:375–382.

17. Becker CM, Swoope CC, Guckes AD. Lingualized occlusion for removable prosthodontics. J Prosthet Dent. 1977; 38:601–608.

18. Carlsson GE. Symptoms of mandibular dysfunction in complete denture wearers. J Dent. 1976; 4:265–270.