[P-130] A case with persistent occlusal discomfort caused by masked premature occlusal contacts
[Abstract]
[Introduction]
A masked malocclusion, which is difficult to detect through ordinary clinical examinations and tests, e.g., slight premature contacts in jaw positions very close to centric occlusion, is considered as one of possible causes of the persistent occlusal discomfort (POD) that does not improve by conventional dental treatments1). For a patient with POD, we carefully examined occlusal condition and detected a slight mandibular slide due to masked premature contacts. This case report presents a good result by correcting the malocclusion using prosthodontic treatments.
[Case Summary and Treatment Details]
The patient was a female in her 70s. Approximately 4 months before visiting our hospital, she underwent provisional restorations treatment for the mandibular anterior teeth at the previous clinic. After wearing provisional restorations, she became aware of occlusal discomfort. She referred to our hospital because no improvement was obtained despite receiving several occlusal treatments in the previous clinic. Systemic diseases and psychiatric disorders were not found. The provisional restorations were attached at 44,43, 42,41,31,32, 33, and removable partial dentures were set at 22~27, 47,46,45,36,37. Overjet was -2.0 mm with a reverse articulation. Careful occlusal examination at the muscular contact position with relaxed jaw muscles revealed existence of premature contacts in the 42,41,31,32, and slight mandibular sliding to forward before converging to the maximal intercuspal position. A new 42,41,31,32 provisional bridge without premature contact was made to confirm the relationship between premature contacts and POD. For making the new provisional bridge, careful occlusal adjustment was performed to prevent premature contact, and occlusal discomfort was disappeared. After confirming the improvement of the chief complaint, the final prosthodontics, i.e., 44,43,42,41,31,32,33 fixed prosthesis and removable partial dentures were set.
[Progress and Discussion]
After completion of prosthodontic treatments, periodical observation in every 3 months was performed and 2years and 8months has passed with good condition and feeling. This report demonstrated that POD can be caused by the masked premature contact hard to detect.
[References]
1)Tamaki K, Ishigaki S, Ogawa T et al. Japan Prosthodontic Society position paper on "occlusal discomfort syndrome". J Prosthodont Res. 2016;60:156-66. doi: 10.1016/j.jpor.2015.11.002.
[Introduction]
A masked malocclusion, which is difficult to detect through ordinary clinical examinations and tests, e.g., slight premature contacts in jaw positions very close to centric occlusion, is considered as one of possible causes of the persistent occlusal discomfort (POD) that does not improve by conventional dental treatments1). For a patient with POD, we carefully examined occlusal condition and detected a slight mandibular slide due to masked premature contacts. This case report presents a good result by correcting the malocclusion using prosthodontic treatments.
[Case Summary and Treatment Details]
The patient was a female in her 70s. Approximately 4 months before visiting our hospital, she underwent provisional restorations treatment for the mandibular anterior teeth at the previous clinic. After wearing provisional restorations, she became aware of occlusal discomfort. She referred to our hospital because no improvement was obtained despite receiving several occlusal treatments in the previous clinic. Systemic diseases and psychiatric disorders were not found. The provisional restorations were attached at 44,43, 42,41,31,32, 33, and removable partial dentures were set at 22~27, 47,46,45,36,37. Overjet was -2.0 mm with a reverse articulation. Careful occlusal examination at the muscular contact position with relaxed jaw muscles revealed existence of premature contacts in the 42,41,31,32, and slight mandibular sliding to forward before converging to the maximal intercuspal position. A new 42,41,31,32 provisional bridge without premature contact was made to confirm the relationship between premature contacts and POD. For making the new provisional bridge, careful occlusal adjustment was performed to prevent premature contact, and occlusal discomfort was disappeared. After confirming the improvement of the chief complaint, the final prosthodontics, i.e., 44,43,42,41,31,32,33 fixed prosthesis and removable partial dentures were set.
[Progress and Discussion]
After completion of prosthodontic treatments, periodical observation in every 3 months was performed and 2years and 8months has passed with good condition and feeling. This report demonstrated that POD can be caused by the masked premature contact hard to detect.
[References]
1)Tamaki K, Ishigaki S, Ogawa T et al. Japan Prosthodontic Society position paper on "occlusal discomfort syndrome". J Prosthodont Res. 2016;60:156-66. doi: 10.1016/j.jpor.2015.11.002.