Patient: An 81-year old female presented to the dental office with a chief complaint of masticatory dysfunction and bad appearance due to missing teeth in the maxillary and mandibular regions and loss of maxillary frontal fixed partial denture. After evaluating the vertical dimension of occlusion, she was diagnosed as infraocclusion. Provisional restorations and treatment dentures were used for occlusal elevation, then the final prosthetic restoration was placed.

Discussion: Provisional restorations, treatment dentures and final prosthetic placement were successful without the patient experiencing temporomandibular dysfunctions by determining the appropriate morphological and physiological vertical dimension of occlusion.

Conclusion: In this case, occlusal elevation and occlusal reconstruction improved masticatory dysfunction and aesthetics.

Patient: The patient was a 39-year-old male with the chief complaints of esthetic problems and masticatory disorder arising from teeth attrition. Oral rehabilitation applying crown restorations based on bite rising was performed.

Discussion: The treatment was planned using a study model and diagnostic wax-up, and was prepared for provisional restorations. Vertical stop in the molars and improvement of esthetics of the anterior teeth were achieved by crown restorations after the vertical dimension was increased by 2 mm for the lower arch.

Conclusion: This case indicates that providing a suitable occlusal vertical dimension and occlusal scheme for functional movement leads to longevity and predictability.

Patient: A 72-year-old woman presented with a chief complaint of inadequate mandibular denture retention. Her maxillary teeth consisted of a full-mouth fixed prosthesis. Even after determination of the shape and vertical dimension of the new denture, the patient was not satisfied with it and therefore flapless implant surgery was performed using a stereolithographic surgical guide. Four months later, an overdenture was put in place using ball abutments.

Discussion: The stability of the implant overdenture was improved by the retention force of the ball abutments. The patient was satisfied with the improvement of her masticatory function.

Conclusions: This case indicates that an implant overdenture is an effective option for a mandibular single denture in patients with severely atrophic mandible to provide sufficient support, bracing and retention capabilities.

Patient: The patient was a 54-year-old female with a chief complaint of occlusal pain on the abutment teeth of a cross-arch fixed prosthesis. The abutment teeth were extracted and the prosthesis was altered from a cross-arch fixed prosthesis to a removable prosthesis with the fabrication of a telescopic crown-retained denture.

Discussion: When altering from a cross-arch fixed prosthesis to a removable prosthesis, psychological discomfort for the patient is a concern due to the addition of a large connector placed across the palate. By using a telescopic crown-retained denture, we were able to fabricate a removable prosthesis which avoided discomfort caused by large connectors.

Conclusions: For this patient in need of altering from a cross-arch fixed prosthesis to a removable prosthesis after the extraction of an abutment tooth, prosthetic treatment with a telescopic crown-retained denture helped avoid psychological discomfort caused by large connectors leading to an improvement in the patient’s oral-related QOL.

Patient: A 67-year-old male patient visited the hospital with the chief complaint of maxillary anterior teeth mobility and difficulty of mastication and was diagnosed as having cosmetic disturbance and dysmasesis owing to the inadaptation of dentures. Immediate placement of dentures restored the esthetics and masticatory function, and the occlusal support was restored by repairing the mandibular dentures. Good long-term prognosis was achieved by definitive dentures using the functional impression and altered cast technique.

Discussion: It is thought that a functional impression controls the depression of the denture base, stabilizes the dentures, and reduces the load on abutment teeth.

Conclusions: In this case, the partial dentures restored the esthetics and masticatory function, and the functional impression by the altered cast technique reduced the load on abutment teeth, and increased the long-term stability of the dentures.

Patient: The patient was a 59-year-old man whose chief complaints were esthetic dissatisfaction and difficulty in chewing due to removal of partial dentures in the maxillary anterior region. The occlusal vertical dimension was increased by provisional restoration for occlusal reconstruction. Subsequently, implant-supported fixed prostheses were fabricated for the maxillary anterior region.

Discussion: A night guard was provided to the patient after delivery of the final prostheses, and the patient was recalled periodically. The patient is very satisfied with this treatment without any specific problems during the 3-year follow-up period.

Conclusions: The implant treatment with bite rising mitigated the esthetic dissatisfaction and difficulty in chewing of this patient who was suffering from decreased vertical dimension and intermediary defect in the maxillary anterior region.

Patient: The patient was a 64-year-old man with a chief complaint of masticatory disturbance caused by both postoperative tongue movement dysfunction after resection of carcinoma of the floor of the mouth and severe periodontal disease.

After the initial periodontal therapy, full mouth reconstruction was performed with a fixed partial denture and a lingual flange-shaped mandibular removable partial denture improved by using the treatment denture.

The OHIP-J 54 was employed for functional assessment to evaluate the mastication ability and patient satisfaction before and after treatment.

Discussion: Final prosthesis placement enhanced patient satisfaction and improved mastication ability. It is important to maintain the stability of the occlusal support by the remaining teeth and to minimize the number of missing teeth for maxillofacial prosthesis.

Conclusions: The improvement of oral function was attributed to the oral preparation extended to the fixed prosthesis placement and the treatment denture to determine the flange shape in harmony with oral functional movement.

Patient: A 65-year-old woman presented with the main complaint of difficulty while chewing. She had repeatedly sanded her teeth with sandpaper to remove a sense of discomfort from the occlusion. All of her teeth crowns were scraped significantly. The final restoration managed to reproduce the provisional restoration. The occlusal plane and jaw position were obtained by various examinations and repeated fine adjustments.

Discussion: The correct mandibular position was obtained by the proper provisional restoration, which was examined and adjusted carefully, bringing about the successful result.

Conclusion: Determination of the appropriate mandibular position has a significant impact on the prognosis of patients. In this case, the mandibular position was determined using several methods and yielded a long-lasting positive outcome.

Patient: A 78-year-old female presented with a chief complaint of mastication difficulty using upper and lower complete dentures. The lower denture was supported by magnetic attachments for implant abutments, but it was poorly maintained and unstable due to an excessively narrow base area. To resolve the mastication disorder, the prosthetic space was calculated using piezography, and a denture with lingualized occlusion was created.

Discussion: The morphology of the new denture fitting the perioral muscles and the tongue, as well as magnetic attachment use and lingualized occlusion, improved the maintenance level and stability, increasing patient satisfaction.

Conclusions: To obtain favorable outcomes in patients using complete dentures with marked mandibular residual ridge resorption, positioning artificial teeth in consideration of perioral muscles and tongue movements and designing morphologically appropriate denture bases may be important.