Rehabilitation of a patient with crossed occlusion using mandibular implant-supported fixed and maxillary Kennedy class IV removable dental prostheses: A case report

엇갈린 교합 환자의 임플란트 지지 고정성 보철물과 Kennedy class IV 가철성 국소의치를 이용한 수복 증례

  • Kang, Seok-Hyung (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Han, Jung-Suk (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Kim, Sung-Hun (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Yoon, Hyung-In (Department of Prosthodontics, Seoul National University School of Dentistry) ;
  • Yeo, In-Sung (Department of Prosthodontics, Seoul National University School of Dentistry)
  • 강석형 (서울대학교 치의학대학원 치과보철학교실) ;
  • 한중석 (서울대학교 치의학대학원 치과보철학교실) ;
  • 김성훈 (서울대학교 치의학대학원 치과보철학교실) ;
  • 윤형인 (서울대학교 치의학대학원 치과보철학교실) ;
  • 여인성 (서울대학교 치의학대학원 치과보철학교실)
  • Received : 2017.08.10
  • Accepted : 2017.09.14
  • Published : 2017.12.01


The term, 'crossed occlusion' implies clinical situation in which the residual teeth in one arch have no contact with those in the antagonistic arch, resulting in the collapse of occlusal vertical dimension. The treatment goal of this pathologic condition is restoration of the collapsed vertical dimension and stabilization of abnormal mandibular position. Previously, konus removable prostheses or tooth supported overdentures were suggested to solve crossed occlusion. Nowadays, dental implants have been used for definitive support to solve this problem. In this case report, a 65 years old female patient had a crossed occlusion, in which the maxillary posterior residual teeth and mandibular anterior residual teeth cross. Interim removable and fixed dental prostheses were used to confirm the proper vertical and horizontal jaw relation. After that, the mandibular posterior edentulous region was restored with implant-supported fixed dental prostheses. Computer tomography guided implant surgery was performed according to the concept of the restoration-driven implant placement. The maxillary anterior edentulous region was restored with Kennedy class IV removable prosthesis, considering the patient's economic status. The patient's jaw position and prostheses have been well maintained at the follow-up after 6 months of definitive restoration. The antero-posterior crossed occlusion problems appeared to be effectively solved with the combination of removable in one arch and implant-supported fixed prostheses in the other.



  1. Obana J. Prosthodontic treatment for maxillary and mandibular teeth cross each other "Eichner classification C1", 37-48. Tokyo: Ishiyaku Publishers, Inc, 1994.
  2. Abe et al.,엇갈린 교합의 보철 / 阿部實.. [등저] ; 박남수 ; 이대균 ; 이성복 공역., 서울: 지성출판사,1995.
  3. Pleasure MA. Correct vertical dimension and freeway space. The Journal of the American Dental Association 1951;43:160-163.
  4. Willis FM. Features of the face involved in full denture prosthesis. Dent Cosmos 1935;77:851-854.
  5. Kayser AF. Shortened dental arches and oral function. J Oral Rehabil 1981;8:457-462.
  6. Zarb GA, MacKay HF. Cosmetics and removable partial dentures--the class IV partially edentulous patient. J Prosthet Dent 1981;46:360-368.
  7. Stern N, Brayer L. Collapse of the occlusion--aetiology, symptomatology and treatment. J Oral Rehabil 1975;2:1-19.
  8. Kwon T-M, Seo C-W, Kim K-A, Ahn S-G, Seo J-M. Full mouth rehabilitation of a partially edentulous patient with crossed occlusion using implant-retained RPD with zirconia occlusal table. Journal of Dental Rehabilitation and Applied Science 2016;32:314-321.
  9. Dong-Woon K, Jung-Yun C, Jae-Min S, Jung-Jin L. Rehabilitation of a crossed-occlusion patient using implant-assisted removable partial denture with Locator(R) attachment : A case report. THE JOURNAL OF THE KOREAN DENTAL ASSOCIATION 2016;54:513-520.
  10. Lee YJ, Leesungbok R, Lee SW, Park SJ, Ahn SJ. Implant supported removable dental prosthesis with magnetic attachment in crossed occlusion: A case report. The Journal of Korean Academy of Prosthodontics 2017;55:53.
  11. Kanno T, Carlsson GE. A review of the shortened dental arch concept focusing on the work by the Kayser/Nijmegen group. J Oral Rehabil 2006;33:850-862.
  12. Carr AB. McCracken's removable partial prosthodontics. In: Brown DT (ed). McCracken's Removable Partial Prosthodontics, 13th Edition: [Place of publication not identified] Elsevier, 2016.