J Dent Rehabil Appl Sci.  2016 Sep;32(3):224-231. 10.14368/jdras.2016.32.3.224.

Full mouth rehabilitation on the patient with severe tooth wear and tooth fracture using reestabilishment of occlusal vertical dimension

Affiliations
  • 1Department of Prosthodontics, School of Dentistry, Chosun University, Gwangju, Republic of Korea. lkj1998@chosun.ac.kr

Abstract

Severe dental attrition causes pathological changes of the tooth, imbalanced occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension that can incur temporomandibular joint and muscular complications. Before restoring the vertical dimension with full-mouth prosthetic restorations, it is important to determine the amount of vertical lifting through complete diagnosis. In this study, a 59 year-old male patient with generalized attrition and fracture of teeth was treated with full-mouth zirconia prosthetic restoration in order to recover vertical dimension and aesthetics. Through the analysis of physiologic rest position and inter-canine distance, the treatment was planned for lifting 3 mm in vertical dimension. Interim crown were fabricated after full-mouth wax up, having the patient use for 6 months. The final monolithic and bilayered zirconia restorations were completed. The patient showed satisfaction in function and aesthetics for 18 months of follow-up since delivering the final restorations.

Keyword

dental attrition; full-mouth prosthetic restoration; zirconia; vertical dimension

MeSH Terms

Crowns
Diagnosis
Esthetics
Follow-Up Studies
Humans
Lifting
Male
Mouth Rehabilitation*
Mouth*
Temporomandibular Joint
Tooth Attrition
Tooth Fractures*
Tooth Wear*
Tooth*
Vertical Dimension*

Figure

  • Fig. 1 Intra-oral status in the initial examination. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

  • Fig. 2 Pre-treatment panoramic radiograph.

  • Fig. 3 Lateral skull radiograph shows enlarged sella turcica.

  • Fig. 4 Diagnostic wax up model with new occlusal vertical dimension. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

  • Fig. 5 1st provisional restoration. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

  • Fig. 6 Gothic arch tracing. (A) Gothic arch tracer on maxillary arch, (B) Gothic arch tracer on mandibular arch, (C) Gothic arch apex represented centric relation.

  • Fig. 7 2nd provisional restoration. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

  • Fig. 8 Cut-back zirconia coping design in CAD/CAM software. (A) Maxillary occlusal view, (B) Mandibular occlusal view.

  • Fig. 9 Final prosthesis. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.


Reference

References

1. Dombrady L. Investigation into the transient instability of the rest position. J Prosthet Dent. 1966; 16:479–90. DOI: 10.1016/0022-3913(66)90052-7.
2. Tallgren A, Lang BR, Walker GF, Ash MM Jr. Changes in jaw relations, hyoid position, and head posture in complete denture wearers. J Prosthet Dent. 1983; 50:148–56. DOI: 10.1016/0022-3913(83)90002-1.
3. Dawson PE. Functional occlusion from TMJ to smile design. 1st ed. Amsterdam: Elsevier;2008. p. 114–22.
4. Monteith B. The role of the freeway space in the generation of muscle pain among denture wearers. J Oral Rehabil. 1984; 11:483–98. DOI: 10.1111/j.1365-2842.1984.tb00601.x. PMID: 6239019.
5. Appleby DC, Cilento PA. Malocclusion secondary to acromegaly: a case report. Compendium. 1993; 14:950–2. PMID: 8242672.
6. Jadresic A, Banks LM, Child DF, Diamant L, Doyle FH, Fraser TR, Joplin GF. The acromegaly syndrome. Relation between clinical features, growth hormone values and radiological characteristics of the pituitary tumors. Q J Med. 1982; 51:189–204. PMID: 7111679.
7. Dons RF, Rieth KG, Gorden P, Roth J. Size and erosive features of the sella turcica in acromegaly as predictors of therapeutic response to supervoltage irradiation. Am J Med. 1983; 74:69–72. DOI: 10.1016/0002-9343(83)91120-8.
8. Counsil of Fixed Prosthodontic Professor. Fixed prosthodontics - principle and clinic. 1st ed. Seoul: DaehanNarae Publishing;2012. p. 6.
9. Cohen RB, Wilcox CW. A case of acromegaly identified after patient complaint of apertognathia. Oral Surg Oral Med Oral Pathol. 1993; 75:583–6. DOI: 10.1016/0030-4220(93)90229-W.
10. Markovic M, Triscovic D. Some results of occlusal and metric analysis of acromegalic cases. Int J Orthod. 1978; 16:13–20. PMID: 280541.
11. Mohamed SE, Christensen LV. Mandibular reference positions. J Oral Rehabil. 1985; 12:355–67. DOI: 10.1111/j.1365-2842.1985.tb01290.x.
12. Siverman MM. The speaking method in measuring vertical dimension 1952. J Prosthet Dent. 2001; 85:427–31. DOI: 10.1067/mpr.2001.116139.
13. Turrell AJ. Clinical assessement of vertical dimension. J Prosthet Dent. 1972; 28:238–46. DOI: 10.1016/0022-3913(72)90216-8.
14. Willis FM. Features of the face involved in full denture prosthesis. Dent Cosmos. 1935; 77:851–4.
15. Rivera-Morales WC, Mohl ND. Relationship of occlusal vertical dimension to the health of the masticatory system. J Prosthet Dent. 1991; 65:547–53. DOI: 10.1016/0022-3913(91)90298-B.
16. Oh WS, Delong R, Anusavice KJ. Factors affecting enamel and ceramic wear: a literature review. J Prosthet Dent. 2002; 87:451–9. DOI: 10.1067/mpr.2002.123851.
17. Ozkurt Z, Kazazo lu E. Clinical success of zirconia in dental applications. J Prosthodont. 2010; 19:64–8. DOI: 10.1111/j.1532-849X.2009.00513.x. PMID: 19754642.
18. Bachhav VC, Aras MA. Zirconia-based fixed partial dentures: a clinical review. Quintessence Int. 2011; 42:173–82. PMID: 21359252.
19. Sato S, Hotta TH, Pedrazzi V. Removable occlusal overlay splint in the management of tooth wear: a clinical report. J Prosthet Dent. 2000; 83:392–5. DOI: 10.1016/S0022-3913(00)70032-1.
20. Wood GN. Centric relation and the treatment position in rehabilitating occlusions: a physiologic approach. Part II: the treatment position. J Prosthet Dent. 1988; 60:15–8. DOI: 10.1016/0022-3913(88)90341-1.
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