Onlay partial denture

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

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

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

4. 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 http:dent.ghil.com/

5. 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) http:dent.ghil.com/

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

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

8. 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 http:dent.ghil.com/

9. C. Methods of evaluation • Phonetic evaluation : speaking space를 이용 하는 방법에는 “S” sound시 하악 전치의 incisal edge가 상악 incisal edge에 비해 1mm 정도 inferior and lingual에 위치함, 1mm이상의 차이가 있을시 VD의 loss가 있다고 봄 http:dent.ghil.com/

10. C. Methods of evaluation • Inter-occlusal distance ; VDO, VDR에서 3mm 이상 차이가 있으면 excessive wer가 있다고 본다. 재는 방법에 따라 논란이 많음. 그러나 complete denture환자에 있어서 VD재는 방법을 이용하기도 하고 myomonitor를 이용하기도 한다. http:dent.ghil.com/

11. Approaching technique • OVD를 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 http:dent.ghil.com/

12. http:dent.ghil.com/

14. Interim removable partial denture http:dent.ghil.com/

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

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

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

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

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

20. 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 http:dent.ghil.com/

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

23. 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 http:dent.ghil.com/

24. 어떤 방법으로 제작할까? http:dent.ghil.com/

29. http:dent.ghil.com/