[in Japanese]

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[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

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[in Japanese]

View full abstract

[in Japanese]

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Patient: A 61-year-old male presented with the chief complaint of difficulty in chewing caused by missing lower teeth. In this case, radiation therapy (malignant lymphoma) was performed for the left mandible, and three implants were inserted in the right mandible. An overdenture (Konus telescope denture) was selected for the final prosthesis.
Discussion: The final prosthesis had mechanical problems. A complicated design of the prosthesis was necessary to achieve satisfactory esthetic and functional results. Frequent periodic observation and re-evaluation are needed.
Conclusion: Functional problems caused by loss of occlusal support were successfully rehabilitated using an implant-retained removable partial denture.

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Patient: The patient was an 81-year-old edentulous woman with the chief complaints of poor retention of a maxillary denture and pain in the mucosa under the base of a mandibular denture. Flabby gum was observed extensively from the anterior to the premolar extent of the maxilla. Improved dentures were fabricated that corrected the horizontal maxillomandibular relationship by Gothic arch tracing.
Discussion: Denture stability and retention were improved by considering the optimum dimensions and occlusion for the flabby gum, and thus the patient’s chief complaints were improved.
Conclusion: Improved denture stability and retention were obtained for the patient by providing center of occlusion balance in the molars.

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Patient: A 67-year-old male patient with right-side mandibulectomy with discontinuity defect was referred to our clinic. He had received segmental resection of the right mandible and reconstruction with a plate, however, the reconstructed plate had failed. Maxillectomy was planned due to osteomyelitis associated with osteopetrosis, therefore a immediate surgical obturator was fabricated prior to the operation.
Discussion: Severe deviation of the mandible caused few intermaxillary occlusal contacts and unstable occlusion. The ramp on the maxillary prosthesis not only prevented leakage but also provided stability of occlusion.
Conclusion: The maxillary obturator prosthesis with palatal ramp effectively improved functional and esthetic impairments in this patient with discontinuity mandibulectomy with deviated mandibular movement and malocclusion.

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Patient: A 58-year-old female patient is reported. She visited the clinic complaining of esthetic disturbance by discolored oral restorations and secondary caries. First, she received periodontal treatment, tooth extraction, composite resin filling and minor tooth movement. Then, provisional restorations and esthetic prostheses of natural tooth color were placed, and the patient was observed.
Discussion: The occlusal surfaces of the posterior teeth were covered with hybrid composite resin. Because there was a possibility of causing a decrease in the occlusal vertical dimension in the long term, the upper second molar teeth were restored by metal crowns with abrasion resistance.
Conclusion: Discolored oral restorations and secondary caries were replaced by esthetic prostheses of natural tooth color and the unstable intercuspal position was improved by the prostheses.

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Patient: A 32-year-old male patient diagnosed as maxillary ameloblastoma was introduced to our prosthodontic clinic by an oral surgeon before oral surgery. As a 8+3 maxillary defect was expected after surgery, an early post-operative dento-maxillary prosthesis in which the patient’s teeth, gums and plate were duplicated, was fabricated from the pre-operative maxillary pattern. The patient used the prosthesis with obturator for functional and esthetic rehabilitation until the final maxillofacial prosthesis was fabricated 12 months after surgery.
Discussion: In this case, it was possible to fabricate the early post-operative dento-maxillary prosthesis which reproduced the dentition before an operation by taking an impression before the operation. The form and functional recovery could be planned at an early stage compared with the case of intervention after the operation.
Conclusion: Functional rehabilitation was possible at an early post-operative stage by prosthetic dentistry intervention before an operation.

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Patient: The patient was a 61-year-old female who visited our hospital with the chief complaint of difficulty in mastication when wearing dentures. Occlusal support had been lost in the molar region, and mild mobility of the upper incisors was noted. Occlusal reconstruction with dental implants was considered, however, the bone volume of the maxillary molar region was poor, preventing implant placement in the maxilla. The final prostheses selected were a removable denture for the maxilla and an implant superstructure for the mandible.
Discussion: The occlusal relationship and fitting of the denture base were favorable at 3 years after the completion of treatment. The upper incisors revealed neither median diastema nor labial inclination and reduced tooth mobility, therefore it was suggested that occlusal reconstruction in the molar region had reduced the load on the upper incisors.
Conclusion: Occlusal reconstruction in the molar region improved the masticatory function and reduced the load in the upper incisors.

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Patient: An 18-year-old male visited our department with a masticatory disturbance arising from a root fracture in the maxillary left central incisor, which had to be extracted. For bridge treatment, a full-coverage porcelain fused to a metal crown was applied to the abutment tooth of the maxillary left lateral incisor because the tooth was a restored microdont. The other abutment tooth of the maxillary right central incisor was an intact tooth; therefore, a resin-bonded retainer was applied using a pin technique to strengthen the retention.
Discussion: Over 7 years of follow-up, no prosthetic complications were observed, and the patient was satisfied with the treatment outcome.
Conclusion: In the case of a resin-bonded prosthesis containing a one-sided full-coverage crown, the combined use of pin and resin-bonded techniques on the other adhesion retainer enabled minimal intervention dentistry and long-term retention of the prosthesis and resulted in high patient satisfaction.

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Patient: The patient was a 60-year-old female, with dental anxiety and complaints of masticatory dysfunction and esthetic dissatisfaction. The treatment denture was placed after tooth extraction, then the definitive denture was placed 6 months later. This treatment showed a good prognosis 4 years later.
Discussion: It is suggested that the main factor of success in this treatment was clarifying the cause of the dental anxiety from the patient during history-taking. In addition, although the patient had dental anxiety, modification of the esthetic appearance changed her motivation toward dental treatment.
Conclusion: To reduce the fear of dental treatment and to recognize improvements in the oral condition, it may be possible to perform prosthodontic treatment for patients with dental anxiety.

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Patient: A 35-year-old male complained of poor esthetic appearance caused by reversed occlusion of anterior teeth. Inclination of the maxillary anterior teeth and depression of the anterior alveolar region were observed. Orthodontic treatment and surgical orthodontic treatment were performed with the diagnosis of reversed occlusion due to maxillary undergrowth. All-ceramic crowns were placed as a final restoration on the anterior teeth and an implant.
Discussion: After implant placement, optimal modification of the maxillary anterior teeth axis and dental implant position by surgical orthodontic treatment effectively improved the esthetic appearance, mastication and articulation.
Conclusion: Good esthetic appearance was obtained as a result of surgical orthodontic treatment and prosthetic restoration for this case which required improvement of dentition including the alveolar process.

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Patient: The patient was a 75-year-old woman who presented with the chief complaint of mastication disorder due to abnormal mandibular denture and pain in 43 and 44. The existing denture showed a reduction of the occlusal vertical dimension and disorder of the occlusal plane up to the anterior nasal spine in the maxilla and the mental spine in the mandible.
Discussion: Improved dentures were fabricated that corrected the horizontal maxillomandibular relationship by Gothic arch tracing. The cause appeared to be poor biting habit due to pain in 43 and 44 for a long time and abnormal mandibular denture. The chief complaint of mastication disorder was improved by using the treatment denture.
Conclusion: Improved denture stability and favorable outcomes were obtained for the patient by using a treatment denture after attaching a new denture.

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Patient: A 40-year-old male complained of masticatory dysfunction and esthetic disturbance. The masticatory dysfunction appeared to be due to a discrepancy between the maxillo and mandibular dental arch form, affected by lack of occlusal contact in the centric occlusal position. A treatment denture was made to increase the occlusal vertical dimension, based on physiologic and morphologic ways. Finally, a removable partial denture was constructed after following up the increase in occlusal vertical dimension for 6 months.
Discussion: Masticationary function as functional recovery and cephalogram analysis as morphological recovery were evaluated before and after treatment.
Conclusion: In this case, masticatory dysfunction and esthetic disturbance were improved by a removable partial denture to increase the occlusal vertical dimension and to ensure occlusal contact inside the dental arch.

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Patient: The patient was an 18-year-old male with congenital partial edentulism presenting with esthetic and mastication disorders related to the edentulous spaces. Surgical orthodontic treatment for improving the mandibular protraction had already been completed before the patient was referred to our department. After clinical examination, the remaining edentulous spaces were corrected by minor orthodontic treatment to improve the condition for further prosthetic rehabilitation. Subsequently, an implant-supported denture for the posterior missing space and fixed partial dentures for the anterior missing space were inserted. Oral health-related quality of life (OHRQOL) was evaluated by a self-administered questionnaire before and after the rehabilitation.
Discussion: Signs of inflammation or progressive bone resorption were not found around the implant fixtures during periodical recalls. Assessment of OHRQOL revealed that the patient’s OHRQOL had improved after insertion of the implant-supported fixed prosthesis (IFPs).
Conclusion: The patient’s OHRQOL was improved after rehabilitation with IFPs based on an interdisciplinary approach in collaboration with orthodontists.

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Patients: A 53-year-old female with the chief complaints of pain of the upper right molar region and pathologic teeth mobility was diagnosed as severe generalized chronic periodontitis with masticatory disorder. Cause-related periodontal therapy and well-established supra-gingival self-performed plaque control by the patient resulted in improvement in periodontal condition. Then, orthodontic treatment and single-implant therapy were performed. The implant was installed along the anterior wall of the maxillary sinus in a tilted manner. Masticatory function and esthetics were recovered by a combined tooth-implant-supported fixed dental prosthesis.
Discussion: The perio-implant-prosthesis based on the shortened dental arch concept led to high satisfaction of this patient with severe generalized chronic periodontitis.
Conclusion: The perio-implant-prosthesis is acceptable under meticulous plaque control by both the patient and dental professional.

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Patient: A 23-year-old female patient visited our department with the chief complaints of poor appearance and masticatory disturbance as a result of congenitally missing secondary teeth. There were several gaps due to loss of the premolar and left second molar on the maxilla, and the second premolar and right second incisor on the mandible. Therefore, prosthetic therapy using a removable partial denture of a metal plate was performed.
Discussion: Favorable results were obtained. The patient was satisfied with the treatments for esthetic and masticatory function during the period of up to 17 years after the final restoration.
Conclusion: A favorable long-term course was obtained as a result of the treatment for esthetic and masticatory disturbance by using a removable partial denture of a metal plate. Furthermore, her intraoral health has been maintained by periodical intraoral inspection and repairs three times to replace the artificial teeth.

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Patient: The patient was a 29-year-old female who had complaints of chewing disturbance and esthetic problems from odontoparallaxis. Signs of occlusal disharmony by oral examination and failure of masticatory function were observed. Improvement of jaw function and left-right imbalance of occlusal contact through comprehensive treatment, including orthodontic treatment, was observed.
Discussion: In cases of occlusal disharmony, the application of appropriate anterior guidance and occlusal contact is important to restore masticatory function. We consider that oral hygiene management, including plaque control, is more easily performed than improving dental malalignment, and reduces the risk of periodontal disease.
Conclusion: For this case of esthetic disturbance caused by occlusal disharmony with odontoparallaxis, good results were obtained by comprehensive treatment, including orthodontic treatment.

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