J Dent Rehabil Appl Sci.  2015 Sep;31(3):262-272. 10.14368/jdras.2015.31.3.262.

Full mouth rehabilitation on the patient with class II jaw relation and posterior bite collapse using reestablishment of occlusal vertical dimension: a case report

• Kim JH
• Cho HW
• Jung JH

• KMID: 2180029
• DOI: http://doi.org/10.14368/jdras.2015.31.3.262

Abstract

Loss of molar support and abnormal jaw relationship lead to occlusal disharmony and cause pathologic signs. Full mouth rehabilitations with reestablishment of occlusal schemes are needed. In this case, the 75 year-old female patient showed posterior bite collapse, irregular occlusal plane and Class II jaw relationship. By observing her profile and interocclusal distance, she was diagnosed as loss of occlusal vertical dimension. Treatment plan is to restore maxillay class I removable partial denture and mandibular fixed prosthesis and to establish vertical dimension and harmonious occlusal plane. Occlusal vertical dimension of 19 mm, which is obtained by 7.5 mm increase between maxillary right lateral incisor and mandibular canine, was established using temporary prosthesis via diagnostic wax-up. Patient adaptation with newly formed vertical dimension was verified during 8 week follow-up period. Within the information of interim prostheses, final restoration was constructed and delivered. The patient showed sound occlusal scheme and esthetic profile.

Keyword

vertical dimension; full mouth rehabilitation; class II jaw relation; posterior bite collapse

MeSH Terms

Dental Occlusion
Denture, Partial, Removable
Female
Follow-Up Studies
Humans
Incisor
Jaw*
Molar
Mouth Rehabilitation*
Mouth*
Prostheses and Implants
Vertical Dimension*

Figure

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  Fig. 1 Panoramic radiograph before treatment.

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  Fig. 2 Intraoral view after extraction of hopeless teeth. (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 Mounted diagnostic model analysis. (A) Posterior collapsed bite on right side and mandibular canine had a contact with soft tissue of maxillary palate, (B) Intergingival distance between zenith lines of right maxillary lateral incisor and mandibular canine was 11.5 mm, (C) MICP contact between the maxillary left 2nd bicuspid and mandibular 1st molar.

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  Fig. 4 Determination of vertical dimension. (A) Physiologic resting position, (B) Measurement of distance between the pupil and mouth corner using Willis method, (C) Measurement of length of lower 1/3 of the face using Willis method.

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  Fig. 5 Diagnostic wax up using new vertical dimension for interim prostheses. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Harmonious occlusal plane establishment using occlusal plane guide, (F) Mandibular occlusal view.

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  Fig. 6 (A) Newly placed temporary fixed partial denture (FPD) after removal of old FPD, (B) New centric relation record with increased vertical dimension.

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  Fig. 7 (A) Mounted models after temporization, (B) Fabrication of customized anterior guide table.

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  Fig. 8 Abutment preparation for definitive prosthesis. (A) Maxillary occlusal view, (B) Mandibular occlusal view.

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  Fig. 9 Deivery of definitive FPDs with increased vertical dimension. (A) Maxillary occlusal view, (B) Mandibular occlusal view.

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  Fig. 10 Definitive prostheses. (A) Maxillary master cast, (B) Maxillary occlusal view of removable partial denture, (C) Right lateral view, (D) Frontal view, (E) Right lateral view, (F) Mandibular working cast, (G) Mandibular occlusal view of metal ceramic restoration.

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  Fig. 11 Establishment of occlusal scheme. (A) Left lateral movement, (B) Right lateral movement, (C) Protrusion.

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  Fig. 12 TMJ radiograph series after treatment. (A) Centric occlusion (Rt side), (B) Maximum opening (Rt side), (C) Maximum opening (Lt side), (D) Centric occlusion (Lt side).

Reference

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