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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