1. Onlay partial denture 嘉泉醫大 吉病院 齒科센터

2. http:dent.ghil.com/ Anterior teeth – attrition Vertical dimension – decrease RPD - abrasion

3. http:dent.ghil.com/ A. Etiology Parafunctional occlusal habits Chronic bruxism Other oral habits : biting on needles, pipe stems, pencils, hairpins

4. http:dent.ghil.com/ A. Etiology Abrasion : diet – chewing of abrasive materials (rice, tabacco) Definition : defined as the wearing away of tooth tissue by external agents Occlusal abrasion is usually attributed to diet, chewing of abrasive. Environment factors : constant exposure to dust and grit

5. http:dent.ghil.com/ A. Etiology Erosion : chemical action Result from excessive intake citrus juices, cola, chronic vomiting Incisal edge, lingual or occlusal surface : cupped-out appearance (unbalanced occlusal force)

6. http:dent.ghil.com/ Evaluation of Vertical Dimension OVD : occlusal vertical dimension VDO : vertical dimension of occlusion VDR : vertical dimension of rest

7. http:dent.ghil.com/ C. Methods of evaluation Posterior support History of wear Phonetic evaluation Inter-occlusal distance Facial appearance

8. http:dent.ghil.com/ C. Methods of evaluation Posterior support Loss of posterior support is the most common cause of decreased occlusal vertical dimension Posterior collapsar : combination of missing, tipping, rotated and broken down teeth

9. http:dent.ghil.com/ C. Methods of evaluation Phonetic evaluation : speaking space 를 이용 하는 방법에는 “S” sound 시 하악 전 치의 incisal edge 가 상악 incisal edge 에 비해 1mm 정도 inferior and lingual 에 위 치함, 1mm 이상의 차이가 있을시 VD 의 loss 가 있다고 봄

10. http:dent.ghil.com/ C. Methods of evaluation Inter-occlusal distance ; VDO, VDR 에서 3mm 이상 차이가 있으면 excessive wer 가 있다고 본다. 재는 방법에 따라 논란 이 많음. 그러나 complete denture 환자 에 있어서 VD 재는 방법을 이용하기도 하 고 myomonitor 를 이용하기도 한다.

11. http:dent.ghil.com/ Approaching technique OVD 를 변화 시키는 치료를 행 할 때는 다음의 원칙을 준수 해야 한다. Concepts of conservative treatment Trial period with interim prosthesis Transitional RPD (desired OVD) Use of acrylic splint Use of provisional restoration

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14. Interim removable partial denture

15. http:dent.ghil.com/ Initial patient assessment Intraoral examination Extraoral examination Smile analysis Phonetic evaluation Initial prostheses assessment

16. http:dent.ghil.com/ Initial patient assessment Intra-oral examination Excessive loss of tooth structure Healthy periodontum with sufficient bone Lack of posterior occlusion Class I jaw relationship

17. http:dent.ghil.com/ Initial patient assessment Extra-oral examination Slight decrease in facial height Inversion of maxillary lip Inter-occlusal rest space of 3 to 4mm

18. http:dent.ghil.com/ Initial patient assessment Smile analysis No touch of maxillary teeth to lower lip Straight maxillary incisal edge alignment to lower lip Increase vestibular space

19. http:dent.ghil.com/ Initial patient assessment Phonetic evaluation F-V position – inadequate in vertival plane S position : acquired “S”sound deficiency

20. http:dent.ghil.com/ Initial patient assessment Initial prostheses assessment Poor plane of occlusion Lack of occlusion as a result of excessive wear of acrylic resin Inadequate border extensions

21. http:dent.ghil.com/ To determinate the VD 4mm increase ( anterior incisor area) Direct assessment technique Diagnostic wax-up technique

23. http:dent.ghil.com/ 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

24. http:dent.ghil.com/ 어떤 방법으로 제작할까 ?

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