Onlay partial denture

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					Onlay partial denture

   嘉泉醫大 吉病院 齒科센터
Anterior teeth – attrition
Vertical dimension – decrease
RPD - abrasion

             A. Etiology
Parafunctional occlusal habits
 Chronic bruxism
 Other oral habits : biting on needles, pipe
  stems, pencils, hairpins

             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

            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

    Evaluation of Vertical
OVD : occlusal vertical dimension
VDO : vertical dimension of occlusion
VDR : vertical dimension of rest

   C. Methods of evaluation
Posterior support
History of wear
Phonetic evaluation
Inter-occlusal distance
Facial appearance

    C. Methods of evaluation
Posterior support
 Loss of posterior support is the most
  common cause of decreased occlusal vertical
 Posterior collapsar : combination of missing,
  tipping, rotated and broken down teeth

   C. Methods of evaluation
Phonetic evaluation : speaking space를 이
용 하는 방법에는 “S” sound시 하악 전치
의 incisal edge가 상악 incisal edge에 비해
1mm 정도 inferior and lingual에 위치함,
1mm이상의 차이가 있을시 VD의 loss가
있다고 봄

   C. Methods of evaluation
Inter-occlusal distance ; VDO, VDR에서
3mm 이상 차이가 있으면 excessive
wer가 있다고 본다. 재는 방법에 따라 논
란이 많음. 그러나 complete denture환
자에 있어서 VD재는 방법을 이용하기도
하고 myomonitor를 이용하기도 한다.

    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

Interim removable partial

  Initial patient assessment
Intraoral examination
Extraoral examination
Smile analysis
Phonetic evaluation
Initial prostheses assessment

    Initial patient assessment
Intra-oral examination
 Excessive loss of tooth structure
 Healthy periodontum with sufficient bone

 Lack of posterior occlusion

 Class I jaw relationship

    Initial patient assessment
Extra-oral examination
 Slight decrease in facial height
 Inversion of maxillary lip

 Inter-occlusal rest space of 3 to 4mm

    Initial patient assessment
Smile analysis
 No touch of maxillary teeth to lower lip
 Straight maxillary incisal edge alignment to
  lower lip
 Increase vestibular space

    Initial patient assessment
Phonetic evaluation
 F-V position – inadequate in vertival plane
 S position : acquired “S”sound deficiency

    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

    To determinate the VD
4mm increase ( anterior incisor area)
Direct assessment technique
Diagnostic wax-up technique

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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