onlay partial denture 嘉泉醫大 吉病院 齒科센터. http:dent.ghil.com/ anterior teeth –...
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Onlay partial denture
嘉泉醫大 吉病院 齒科센터
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Anterior teeth – attritionVertical dimension – decreaseRPD - abrasion
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A. Etiology
Parafunctional occlusal habitsChronic bruxismOther oral habits : biting on needles, pipe ste
ms, pencils, hairpins
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A. Etiology
Abrasion : diet – chewing of abrasive materials (rice, tabacco)Definition : defined as the wearing away of t
ooth tissue by external agentsOcclusal abrasion is usually attributed to die
t, chewing of abrasive.Environment factors : constant exposure to
dust and grit
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A. Etiology
Erosion : chemical actionResult from excessive intake citrus juices, col
a, chronic vomitingIncisal edge, lingual or occlusal surface : cup
ped-out appearance (unbalanced occlusal force)
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Evaluation of Vertical Dimension
OVD : occlusal vertical dimension
VDO : vertical dimension of occlusion
VDR : vertical dimension of rest
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C. Methods of evaluation
Posterior support
History of wear
Phonetic evaluation
Inter-occlusal distance
Facial appearance
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C. Methods of evaluation
Posterior supportLoss of posterior support is the most commo
n cause of decreased occlusal vertical dimension
Posterior collapsar : combination of missing, tipping, rotated and broken down teeth
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C. Methods of evaluation
Phonetic evaluation : speaking space 를 이용 하는 방법에는 “ S” sound 시 하악 전치의 incisal edge 가 상악 incisal edge에 비해 1mm 정도 inferior and lingual에 위치함 , 1mm 이상의 차이가 있을시 VD 의 loss 가 있다고 봄
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C. Methods of evaluation
Inter-occlusal distance ; VDO, VDR 에서 3mm 이상 차이가 있으면 excessive wer 가 있다고 본다 . 재는 방법에 따라 논란이 많음 . 그러나 complete denture환자에 있어서 VD 재는 방법을 이용하기도 하고 myomonitor 를 이용하기도 한다 .
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Approaching technique
OVD 를 변화 시키는 치료를 행 할 때는 다음의 원칙을 준수 해야 한다 .Concepts of conservative treatmentTrial period with interim prosthesis
Transitional RPD (desired OVD)Use of acrylic splintUse of provisional restoration
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Interim removable partial denture
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Initial patient assessment
Intraoral examination
Extraoral examination
Smile analysis
Phonetic evaluation
Initial prostheses assessment
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Initial patient assessment
Intra-oral examinationExcessive loss of tooth structureHealthy periodontum with sufficient boneLack of posterior occlusionClass I jaw relationship
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Initial patient assessment
Extra-oral examinationSlight decrease in facial height Inversion of maxillary lip Inter-occlusal rest space of 3 to 4mm
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Initial patient assessment
Smile analysisNo touch of maxillary teeth to lower lipStraight maxillary incisal edge alignment to lo
wer lip Increase vestibular space
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Initial patient assessment
Phonetic evaluationF-V position – inadequate in vertival planeS position : acquired “S”sound deficiency
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Initial patient assessment
Initial prostheses assessmentPoor plane of occlusionLack of occlusion as a result of excessive wear
of acrylic resin Inadequate border extensions
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To determinate the VD
4mm increase ( anterior incisor area)
Direct assessment technique
Diagnostic wax-up technique
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Mounted diagnostic wax-up
To assess the patient’s tolerance & acceptance of restored OVD
Use face-bow, centric relation, condylar angle (protrusive record, lateral check bite)
Mount the semi-adjustable articulator
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어떤 방법으로 제작할까 ?
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