J Dent Rehabil Appl Sci.  2023 Sep;39(3):119-132. 10.14368/jdras.2023.39.3.119.

Full mouth rehabilitation accompanied by phonetic analysis of a patient with reduction of vertical dimension of occlusion, and inaccurate pronunciation due to numerous tooth loss: a case report

• Park JY
• Kim JJ
• Baik J
• Cha HS
• Lee JH

• KMID: 2549279
• DOI: http://doi.org/10.14368/jdras.2023.39.3.119

Abstract

The loss of posterior occlusal support due to tooth loss is likely to lead to compensatory protrusion and labial tilt of the anterior teeth, which may be accompanied by a deep bite and a decrease in vertical dimension. The patient may suffer from a decrease in masticatory efficiency, inaccurate pronunciation, facial appearance changes, and temporomandibular joint disorder, so stable occlusal formation with support of posterior occlusion and restoration of vertical dimension is necessary. We report the case of a patient with reduction of vertical dimension, and inaccurate pronunciation due to multiple tooth loss who underwent full mouth rehabilitation with increased vertical dimension accompanied by phonetic analysis and achieved satisfactory functional and aesthetic results.

Keyword

full mouth rehabilitation; phonetic analysis; vertical dimension

Figure

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  Fig. 1 Panoramic radiograph before treatment.

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  Fig. 2 Intraoral photograph at first visit. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 3 Diagnostic cast analysis on semi-adjustable articulator. (A) Right loss of occlusal contact, (B) Maxillary occlusal view, (C) Left loss of occlusal contact, (D) Right lateral view, (E) Frontal view, (F) Left lateral view, (G) Mandibular occlusal view.

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  Fig. 4 Formant value in phonetic analysis with Praat test before treatment.

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  Fig. 5 Vertical dimension evaluation. (A) Willis’ method; frontal view (*IPL: interpupillary line, *ICL: intercomissural line), (B) Lateral view, (C) Intra-oral analysis; distance between the vestibules.

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  Fig. 6 Vertical dimension determination. (A) Willis’ method; distance between the pupil of the eye and the rima oris (*IPL: interpupillary line, *ICL: intercomissural line), (B) Willis’ method; distance between the base of the nose and lower border of the chin, (C) Lateral view of the occlusal plane.

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  Fig. 7 Diagnostic wax-up. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 8 Provisional restoration. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 9 Transcranial View of TMJ. (A) Right TMJ at rest, (B) Right TMJ at maximum opening, (C) Left TMJ at rest, (D) Left TMJ at maximum opening ( condylar height fossa).

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  Fig. 10 Final tooth preparation & impression taking (A, E) Tooth preparation, (B, F) Impression body obtained by individual tray with polyether, (C, G) Master cast, (D, H) Die model.

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  Fig. 11 (A) Bite registration using the distance between the cervical line of the lateral incisor (#12) and the canine(#43), (B) Facebow transfer, (C) Mounting of master cast.

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  Fig. 12 (A - C) Metal coping try in, (D - F) Definitive prosthesis on master cast.

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  Fig. 13 (A) #11 tooth alteration, (B) Border molding of individual tray, (C) Impression body obtained by individual tray with polyvinylsiloxane, (D) #15 tooth clasp & rest design, (E) Metal framework and wax rim, (F) Bite registration.

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  Fig. 14 Intraoral photograph after definitive treatment. (A) Maxillary occlusal view, (B) Left lateral view, (C) Frontal view, (D) Right lateral view, (E) Mandibular occlusal view.

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  Fig. 15 Formant value in phonetic analysis with Praat test after treatment.

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  Fig. 16 Formant 1, 2 values from Praat analysis before and after treatment.

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  Fig. 17 Widening of vowel space measured by Praat Formant (F1, F2) test during ‘a’, ‘i’, and ‘u’ sound.

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  Fig. 18 Extraoral photograph and radiographic evaluation after definitive treatment (A, B) Facial photo before treatment, (C, D) Facial photo after treatment, (E) Smile photo after treatment, (F) Post-operative panoramic radiograph.

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  Fig. 19 #15 tooth periapical radiograph (A) After tooth preparation, (B) 3 month later after provisionalization, (C) 6 month later after definitive treatment, (D) 1 year later after definitive treatment (E) 1.5 year later after definitive treatment.

Reference

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