J Dent Rehabil Appl Sci.  2022 Sep;38(3):162-170. 10.14368/jdras.2022.38.3.162.

Mandibular full-arch rehabilitation with increased vertical dimension of a patient with severe tooth wear

• Kim HJ
• Kim JJ
• Baik J
• Cha HS
• Lee JH

• KMID: 2535021
• DOI: http://doi.org/10.14368/jdras.2022.38.3.162

Abstract

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.

Keyword

tooth wear; vertical dimension; mouth rehabilitation

Figure

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

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  Fig. 2 Panoramic radiograph before treatment.

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  Fig. 3 Vertical dimension analysis. (A) Frontal view; upper facial height is measured from the pupil of the eye (IPL: interpupillary line) to the rima oris (ICL: intercomissural line), lower facial height is measured from the base of the nose to the lower border of the chin (B) Lateral view, (C) Distance between the vestibules.

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  Fig. 4 Diagnostic model. (A) Right side view, (B) Frontal view, (C) Left side view.

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  Fig. 5 Diagnostic wax up model with increased vertical dimension. (A) Right side view, (B) Frontal view, (C) Left side view, (D) Frontal view of mandible, (E) Lower view of mandible.

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  Fig. 6 Provisional restoration. (A) Right side view, (B) Frontal view, (C) Left side view.

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  Fig. 7 (A) Tooth preparation, (B) Definitive impression taking, (C) Die preparation.

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  Fig. 8 (A) Facebow transfer, (B) Maxillary cast mounting using facebow transfer record.

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  Fig. 9 (A) Full contour wax up, (B) Cut back, (C) Metal coping try in.

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  Fig. 10 Definitive prosthesis. (A) Upper view, (B) Right view, (C) Front view, (D) Left view, (E) Lower view.

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  Fig. 11 Panoramic radiograph after treatment.

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  Fig. 12 Extra-oral photograph. (A) Facial photo before treatment, (B) Facial photo after treatment, (C) Smile photo before treatment, (D) Smile photo after treatment.

Reference

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