8. 3. การออกเสียงพยัญชนะตัว “ส” และ “ซ” (Sibilant sound) (Pound 1962,
1977, Silverman 1952)
• During /s/ sound, the incisal edge of the mandibular incisors about
1-2 mm inferior and lingual to the incisal edge of maxillary incisors.
• More than 1-2 mm may indicated lost occlusal vertical dimension
EVALUATIONS OF VERTICAL DIMENSION OF OCCLUSION
http://www.glidewelldental.com/dentist/inclusive/volume1-4/vertical-dimension-speech.aspx
9. 4. ระยะปลอดการสบ (Freeway space, Interocclusal distance)
(Niswongeer 1934, Pleasure 1941, Thompson 1946)
• Swallowing or /M/ sound
• Average 2-4 mm
• More than 4 mm may indicated lost occlusal vertical
dimension
EVALUATIONS OF VERTICAL DIMENSION OF OCCLUSION
Complex prosthetic rehabilitation due to severe dental wear. Dr. Mauro Fradeani
10. 5. การประเมินรูปร่างของใบหน้า (the evaluation of the Facial soft tissue
contour) (Zarb et al. 1990)
• Diminished facial contour, thin lips with narrow vermillion
boarder, and drooping commissure are associated.
• Golden Proportion also known as 1.681 : 1
EVALUATIONS OF VERTICAL DIMENSION OF OCCLUSION
https://www.tumblr.com/search/golden%20ratio%20face
17. CENTRIC RELATION (CR)
5. Anterior Jig (Lucia Jig)
• First introduced by Lucia (1964)
• Usually made of auto-polymerising acrylic resin
• Separates the posterior teeth helps obtain centric relation by
“de-programming muscles” and allowing the condyles to seat in the
most superior position.
1. http://www.greatlakesortho.com/commerce/detail/?nPID=1362
2. http://www.nature.com/bdj/journal/v196/n7/fig_tab/4811130a_F9.html
19. Category 1 : Excessive wear + Loss VD
TX.
• Provisional Denture
Fixed : Temporary crown or Direct composite
Removable : Occlusal splint or Overlay treatment denture
• Observed periodically for 6-8 weeks + appropriately adjustment
• Final restoration mimic the occlusal vertical dimension, function and esthetic
that have been developed in the treatment restoration.
Mi-Young Song, DDS, MSD, Ji-Man Park, DDS, MSD, Eun-Jin Park*, DDS, MMSc, PhD
Full mouth rehabilitation of the patient with severely worn dentition: a case report
Department of Prosthodontics, School of Medicine, Ewha Womans University, Seoul, Korea,2010
20. Category 2 : Excessive wear
+ Not Loss VD + Have space available
TX.
• Equilibration and/or restoration of the posterior teeth for stability in centric relation.
• Periodontal surgery for gaining clinical crown length is sometimes required for retention and
esthetics.
• Strict parallelism of opposing axial wall is essential, and supplement pins or a grooves
maybe indicated.
Gulab Chand Baid1, Sarandha D Lakshman2, Anand Marilingaiah2, Honey Lunkad3
Comprehensive treatment of compromised dentition: An interdisciplinary approach
1 Department of Prosthodontics, Maitri College of Dentistry and Research Centre, Durg, Chhattisgarh, India
21. Category 3 : Excessive wear
+ Not Loss VD + Not Have space available
TX.
• More difficult because vertical space must be obtain for restorative material.
• Periodontal surgery maybe concern for expose more clinical crown and suitable occlusal
plane.
• A lefort I procedure combined with sectioning the anterior and posterior segment can be
used for intrusionof segment to create interdental space while correcting the dentofacial
deformity.
Manoj Shetty, Niranjan Joshi, D. Krishna Prasad, and Sonali Sood
Complete Rehabilitation of a Patient with Occlusal Wear: A Case Report
J Indian Prosthodont Soc. 2012 Sep; 12(3): 191–197.
25. INTERIM FIXED RESTORATIONS
1.1 Conventional fixed provisional restoration
• Advantage:
• Diagnosis wax-up satisfy with the treatment plan as dentist
shows to the patient
• Disadvantage:
• Restoration may were during the evaluation period therefore may
make long-term management of OVD
• Irreversible tooth preparation
Ming-Yi Chou BSc, DDS, MS, Cert. Prostho, FRCD. Functional and
Esthetic Rehabilitation of Amelogenesis Imperfecta: A Case Report.
2014-11-01
26. 1.2 Direct composite restoration
• Advantage:
• Simple to place, Esthetic to patient with localized anterior tooth wear
and loss of interocclusal space
• Disadvantage:
• Provide moisture control
INTERIM FIXED RESTORATIONS
http://texascenterforocclusalstudies.com/txcos-smile-gallery/
28. TRANSITIONAL REMOVABLE PARTIAL DENTURES
2.1 Overlay removable partial denture
• Advantage:
• Non-invasive, simpler and less expensive than the fixed prosthetic
option
• can normal function including speaking or eating all the time
• Disadvantage:
• Esthetic and functional limitation
• the risks of wear, fracture, or debonding
of occlusal materials are likely to be a
primary failure.
1. Angela T.T. Wong, DMD; Caroline T. Nguyen, DMD, MS. Rehabilitation of a Patient with an
Elusive Medical History and Loss of Occlusal Vertical Dimension. July 2013
2. http://www.goldandceramics.com.au/overlay-denture.html
29. 2.2 Removable acrylic resin occlusal splint
• Advantage:
• non-invasive way to assess a patient’s tolerance to the restored
OVD while preventing further loss of tooth structure
• To decrease myofacial pain when there is evidence of parafunctional
activity.
• Disadvantage:
• The patient have to compliance
• Interfere to eating and speaking.
TRANSITIONAL REMOVABLE PARTIAL DENTURES
http://www.dentalartslab.com/products-services/splintsmouth-guards/dal-comfort-guards/
30. MI-YOUNG SONG, DDS, MSD, JI-MAN PARK, DDS, MSD, AND EUN-JIN PARK, DDS, MMSC, PHD.
FULL MOUTH REHABILITATION OF THE PATIENT WITH SEVERELY WORN DENTITION: A CASE REPORT
J ADV PROSTHODONT. 2010 SEP; 2(3): 106–110
REMOVABLE ACRYLIC RESIN OCCLUSAL SPLINT
31. 2.3 Removable cobalt - chromium appliance with anterior bite plane
(Dahl’ appliance)
• Advantage:
• Extremely conservative
• Disadvantage:
• It is used only for localized severe attrition
• Increased treatment time and extra laboratory procedures
TRANSITIONAL REMOVABLE PARTIAL DENTURES
1. Stephen Robinson, Peter J Nixon, Matthew J Gahan and Martin F W-Y Chan. Techniques for Restoring
Worn Anterior Teeth with Direct Composite Resin. Restorative Dentistry; Dental update, October 2008
2. http://www.mecourse.com/ecourse/wtt/dal3.htm
32. DAHL’ APPLIANCE and ALL CERAMIC CROWN
Michael Botelho, Philip Newsome, Siobhan Owen, David Reaney. The Dahl principle revisited. Irish Dentist July 2011
33. Stephen Robinson, Peter J Nixon, Matthew J Gahan and Martin F W-Y Chan. Techniques for Restoring Worn Anterior Teeth
with Direct Composite Resin. Restorative Dentistry; Dental update, October 2008
DAHL’ APPLIANCE and DIRECT COMPOSITE
RESIN RESTORATION
36. LOSS VD
Cause: ???
1. Severe worn dentition
2. Loss of posterior support
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
37. LOSS VD
• จาเป็นต้อง raise หรือไม่ ?
• Raise เท่าไหร่ ?
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
38. • จาเป็นต้อง raise ?
1. การสบฟันของผู้ป่ วย---Space available for restoration
2. Determination of OVD---Loss of VD ?
• Loss of posterior support
• History of wear (physiologic wear VS excessive wear)
• Phonetic evaluation (the increased space alters /s/ sound
• Interocclusal rest space (greater than 2-4 mm.)
• Facial appearance (Wrinkles and drooping commissures around mouth)
LOSS VD
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
39. • Raise เท่าไหร่ ?: 3 factor for consideration
1. The remaining tooth structure
2. The space available for the restoration
3. Aesthetics
• หลักการ : RVD – OVD = 3 mm. = Freeway space แล้วทาการ raise bite ขึ้นมาใหม่
เพื่อสร้าง Freeway space ประมาณ 2-4 mm.
LOSS VD
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
40. LOSS VD
• Turner’s classification of occlusal wear
• Category 1 : Excessive occlusal wear with loss of vertical dimension with
space available to restore the vertical height.
• Category 2 : Excessive occlusal wear without loss of vertical dimension with
space available.
• Category 3 : Excessive wear without loss of occlusal vertical dimension with
limited space
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
41. OVERLAY REMOVE PARTIAL DENTURE
Mit B Patel and Sompop Bencharit. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable
Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Open Dent J. 2009; 3: 213–218
42. Pre-treatment
During treatment with
provisional denture
Post-treatment
Mi-Young Song, DDS, MSD, Ji-Man Park, DDS, MSD, Eun-Jin Park*, DDS, MMSc, PhD
Full mouth rehabilitation of the patient with severely worn dentition: a case report
Department of Prosthodontics, School of Medicine, Ewha Womans University, Seoul, Korea,2010
43. Pre-treatment
Post-treatment
Manoj Shetty, Niranjan Joshi, D. Krishna Prasad, and Sonali Sood
Complete Rehabilitation of a Patient with Occlusal Wear: A Case Report
J Indian Prosthodont Soc. 2012 Sep; 12(3): 191–197.
44. REFERENCE
1. Vinay Chila Bachhav,* and Meena Ajay Aras. Altering occlusal vertical dimension in functional and esthetic rehabilitation of severely worn dentition. Journal of
Oral Health Research, Volume 1, Issue 1, January 2010
2. Carlsson G, Ingervall B, Kocak G. Effect of increasing vertical dimension on the masticatory system in subjects with natural teeth. J. Prosthet. Dent. 1979;41:284-
9
3. Farhad Fayz, D.M.D., M.S.D.,* and Ahmad Eslami, D.M.D., M.S.**. Determination of occlusal vertical dimension: A literature review. The Journal of Prosthodontic
Dentistry, March 1988, Volume 59, Number 3
4. M. A. Pleasure, D.D.S., M.S.P.H., New York. Correction vertical dimension and freeway space. The Journal of the American Dental Association, Volume 43, August
1951, 160-163
5. Irving M. Sheppard, D.M.D.,* and Stephen M. Sheppard, D.M.D.**. Vertical dimension measurements. J. Prosthet. Dent. September, 1975
6. Meyer M. Silverman, D.D.S. The Speaking Method in Measuring Vertical Dimension. J. Prosthet. Dent. March, 1953
7. Thomas E. J. Shanahan, D.D.S. Physiologic Vertical Dimension and Centric Relation. J. Pros. Den. November 1956
8. Kenneth A Turner, D.D.S.,* and Donald M. Missirlian, D.D.S.**. Restoration of the extremely worn dentition. The Journal of Prosthetic Dentistry, October 1984,
Volume 52, Number 4
9. Mit B. Patel and Sompop Bencharit. A Treatment Protocol for Restorating Occlusal Vertical Dimension Using an Overlay Removable Partial Denture as an
Alternative to Extensive Fixed Restorations: A Clinical Report. The Open Dentistry Journal, 2009, 3, 213-218
10. Mi-Young Song, DDS, MSD, Ji-Man Park, DDS, MSD, Eun-Jin Park*, DDS, MMSc, PhD. Full mouth rehabilitation of the patient with severely worn dentition: a
case report. J Adv Prosthodont 2010; 2; 106-10
11. J Abduo,* K Lyons. Clinical considerations for increasing occlusal vertical dimension: a review. Australian Dental Journal 2012; 57: 2-10
12. Dawson 1989, Fay and Eslami 1988
13. ผศ.ทพญ.กรกช บริพันธกุล; การวินิจฉัยและวางแผนรักษาเพื่อบูรณะมิติแนวดิ่งและทางเลือกในการรักษา. Diagnosis and Treatment Planning in Restoring Vertical Dimension and
Treatment of Choice.
14. อ.ทพ.พิริยะ ยาวิราช; การบูรณะมิติแนวดิ่งของการสบด้วยฟันปลอมติดแน่น. Restore vertical dimension with fixed restorations.
15. บุญชัย เชาวน์ไกลวงศ์ (ทบ., วทม.); การบูรณะมิติแนวดิ่งของการสบด้วยฟันปลอมติดแน่นร่วมกับฟันปลอมถอดได้. Restore Vertical Dimension with Fixed Removable Prosthesis.
16. Michael Botelho, Philip Newsome, Siobhan Owen, David Reaney. The Dahl principle revisited. Irish Dentist July 2011
17. Stephen Robinson, Peter J Nixon, Matthew J Gahan and Martin F W-Y Chan. Techniques for Restoring Worn Anterior Teeth with Direct Composite Resin.
Restorative Dentistry; Dental update, October 2008
18. John Antonelli, DDS, MS., Timothy L. Hottel, DDS, MS, MBA., Sharon C. Siegel, DDS, MS., Robert Brandt, DDS, MS., Gladston Silva, DDS, DMD., The occlusal
guard: a simplified technique for fabrication and equilibration. General Dentistry, May/June 2013
45. 19. การวินิจฉัย การวางแผนการรักษาเพื่อบูรณะมิติในนวดิ่งและทางเลือกในการรักษา,Diasnosis and treatment planning in restoring vertical dimensions and treatment of choice,ผศ.ทพญ. กรกช
บริพนธกุลมChiang-Mai Dental Journal เชียงใหม่ทันตแพทยสาร ปีที่ 21 เล่มที่ 1 เดือน ม.ค. - มิ.ย. พ.ศ. 2543 หน้าที่ 25-35
20. การบูรณะมิติแนวดิ่งของการสบฟันด้วยฟันปลอมติดแน่น,Restore vertical dimension with fixed restoration,อ.ทพ.พิริยะ ยาวิราช
21. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1985;52:467-74.
22. Full mouth rehabilitation of the patient with severely worn dentition: a case report, Mi-Young Song, DDS, MSD, Ji-Man Park, DDS, MSD, Eun-Jin Park*, DDS, MMSc, PhD
Department of Prosthodontics, School of Medicine, Ewha Womans University, Seoul, Korea,2010
23. Comprehensive treatment of compromised dentition: An interdisciplinary approach
Gulab Chand Baid1, Sarandha D Lakshman2, Anand Marilingaiah2, Honey Lunkad3 1 Department of Prosthodontics, Maitri College of Dentistry and Research Centre, Durg,
Chhattisgarh, India
24. Complete Rehabilitation of a Patient with Occlusal Wear: A Case Report Manoj Shetty, Niranjan Joshi, D. Krishna Prasad, and Sonali Sood J Indian Prosthodont
Soc. 2012 Sep; 12(3): 191–197.
25. Milad Azizi. The influence of the leaf gauge and anterior jig on mandibular condyles. November 2001
REFERENCE