Increase In Occlusal Vertical Dimension Research Articles

Influence of occlusal vertical dimension on lip positions at smile in completely dentulous adults.

Aim:The study was conducted to evaluate the effect of increased vertical dimension on the lip positions at smile in dentulous subjects.Settings and Design:Invivo - comparative study.Materials and Methods:Thirty individuals aged between 22 and 30 years were selected for the study. Poly-vinyl siloxane (Jet Bite, Coltene, Switzerland) interocclusal bite records of varying thickness of +1, +2, +3, and +4 mm were made using articulated stone casts for all the participants, respectively. Posed smile photographs at different increased vertical dimensions of +1, +2, +3, and +4 mm were captured with D-SLR camera (Nikon D3200 of 18 megapixels with macro lens, Japan) mounted on tripod stand keeping a uniform distance of five feet from the face. Head positioning device (Genoray CBCT Machine Papaya 3D Plus, Unicorn DenMart, India) was used to stabilize the head position of the participants. Interlabial gap height, intercommissural width, smile index (width/height ratio), incisal edge-to-upper lip distance, incisal edge-to-lower lip distance, and display zone area measurements were made in AutoCAD software (Autodesk, Inc., California, USA).Statistical Analysis Used:One-way repeated measures ANOVA tests (α = 0.05) and Bonferroni's post hoc tests were performed for statistical analysis.Results:With increasing occlusal vertical dimension, the interlabial gap height, incisal edge-to-lower lip distance, and display zone area increased significantly (P < 0.001). The smile index decreased significantly as the occlusal vertical dimension increased (P < 0.001). No significant difference was found in intercommissural width and incisal edge-to-upper lip distance.Conclusion:It was found that an increase in occlusal vertical dimension led to an increase in interlabial gap height, incisal edge-to-lower lip distance, and display zone area measurements, whereas the width of smile and incisal edge-to-upper lip distance did not change with increasing occlusal vertical dimension.

The Survival Of All Ceramic Crowns With A Zirconia Core (Lava™)

Background: Few studies have assessed the survival of restorations and particularly zirconia based crowns in the restoration of the severely worn dentition. This study aimed to determine survival and factors associated with failure in anterior teeth worn through to dentine restored with Lava™ crowns. Methods: A convenience sample of 30 participants (27 male, 3 female) had 161 Lava™ crowns placed by one specialist clinician in a hospital setting. Follow-up was over a median 72 month period. Results: Of the 161 Lava™ crowns only 25 failed (15.5%) in 15 individuals up to 84 months for the longest case. Major failures were total debond (N=7) or minor delamination chips within the veneer ceramic layer (N=18). The mean time to first failure was 25.23 months. The Kaplan Meier survival plot estimated the Mean Survival Time for the crowns to be 74 months (95%CI 70.4, 77.3). Failures by subject were not associated with an increase in Occlusal Vertical Dimension using a Dahl approach but were associated with an edge-to-edge incisal relation (p&lt;0.05), attrition (p&lt;0.05) and bruxism (p&lt;0.005). Conclusion: The Kaplan Meier survival plot estimated the Mean Survival Time for the crowns to be 74 months. The high loads in bruxism result in increased risk of fracture or debond. Clinical relevance: A protective bi-laminar splint is thus advisable. Nonetheless, application of zirconia based crowns in a difficult clinical situation such as bruxism can be a successful treatment modality.

Influence of jaw opening on occlusal vertical dimension between incisors and molars

Statement of problemModification of the occlusal vertical dimension (OVD) is a significant procedure in prosthodontics. Improper estimation of the space available between opposing teeth may lead to an improper framework design. PurposeThe purpose of this clinical study was to evaluate the average opening ratio in the molar area in relation to the extent of opening in the incisor area. Material and methodsA total 34 adults with a complete dentition and stable occlusion participated in the study. The change in vertical distance was evaluated in 3 areas: between the maxillary and mandibular central incisors, between the maxillary and mandibular canines, and between the maxillary and mandibular first molars. Digital photographs were made at the intercuspal position (ICP) and at a 2-mm and 8-mm OVD increase. The OVD opening was standardized with the aid of a Woelfel sliding guide device. The measurements were made by recording the distance between the maxillary and mandibular teeth at different openings. For calibration and quantitative evaluation of the photographs, image-processing analysis was used. ResultsThe collected data showed that the average ratio of the opening between the first molars and the opening between the central incisors was 0.73. The average ratio of the opening between the canines and the opening between the central incisors was 0.95. The values were plotted, and a mathematical model was derived. ConclusionsA vertical dimension opening of 1 mm between the central incisors resulted in 0.73 mm of occlusal clearance in the first molar region and 0.95 mm in the canines.

Two-year observation of the occlusal vertical dimension after bite raising via cone-beam computerized tomography: A preliminary study

Variation of the occlusal vertical dimension (OVD) has been discussed empirically for decades, but it has not been thoroughly explored with experimental data. In the present study, cone-beam computerized tomography (CBCT) of six selected patients was conducted to evaluate the bones of the lower facial structures. The anterior lower facial heights (ALFHs), alveolar process heights (APHs), vertical facial pattern (VFP), occluding dentition height (ODH) and condyle space (CS), which were evaluated by three-dimensional (3D) and two-dimensional (2D) lateral cephalometry derived from CBCT, were compared before and two years after the OVD increased full mouth rehabilitation. Consistent significant increases in ALFHs and the VFP indicated the OVD increase, while a significant decrease in the ΔODH indicated compressed dentition. In addition, 55 of the 56 sites (98.21%) of APH measurement illustrated no significant difference before and after treatment. The findings indicated that the increased OVD did not relapse to baseline and was sufficiently tolerated, with mostly constant APHs and an altered ODH after two years of observation in the six patients.

Prosthetic rehabilitation for a patient treated for embryonal rhabdomyosarcoma

A female patient, now aged 17 years, was diagnosed with rhabdomyosarcoma (RMS) in the right pterygopalatine fossa when she was 3 years old. The RMS was successfully treated by excision, but the subsequent radiation and polychemotherapy resulted in the complete anesthesia of the distribution area of the right trigeminal nerve and loss of vision in the right eye. The patient also experienced pain in the mandibular joints and masticatory muscles. Panoramic radiographs displayed a multiple agenesia of the permanent teeth and underdeveloped apices. Treatment involved the fabrication of a complete maxillary denture. A removable device was fabricated to evaluate her response to an occlusal vertical dimension increase of 6 mm and provide a stable intercuspal position. After wearing the prosthesis for 6 months, the patient reported that she was completely free of symptoms.

Occlusal vertical dimension: Effect on esthetic norms at smile

Background and Objectives: The restorative and esthetic needs for the complete mouth rehabilitation patient frequently require an increase in occlusal vertical dimension (OVD), in whom there would be tooth loss or attrition in existing teeth, decreased OVD, or opposing teeth supraeruption. The effect of increasing OVD for restorative purpose and esthetic norms while smiling is not well understood; hence, the purpose of this study is to evaluate the effect of those norms at smile. Methods: Eighty patients (40 males and 40 females) were selected from the student population of AME's Dental College, Raichur, between the age groups 21 and 30 years, and occlusal registrations of 2, 4, 6, and 8 mm in thickness for each individual were fabricated from the articulated casts. Posed smile images at OVD +0, +2, +4, +6, and +8 were taken with a digital single lens reflex (DSLR) camera and evaluated using AutoCAD software. Results: In this study, it was found that with an increase in OVD, the interlabial gap height, incisal edge to lower lip distance, and display zone area were increased statistically significantly (P

Clinical follow- up of occlusal vertical dimension increase in stainless steel crowns applied with hall technique: A pilot study

Clinical follow- up of occlusal vertical dimension increase in stainless steel crowns applied with hall technique: A pilot study

Ability of General Dentists and Prosthodontists to Discern and Identify Incremental Increases in Occlusal Vertical Dimension in Dentate Subjects

The aim of this study was to determine whether dentists are able to discern and identify increases in occlusal vertical dimension (OVD) in dentate subjects without apparent loss of OVD. A total of 10 dentate subjects had mandibular overlays fabricated at 2-, 3-, 4-, and 5-mm openings of the anterior guide pin (AGP) of a semiadjustable articulator. Standardized frontal and profile photographs with subjects wearing each of the overlays were made. Photographs were presented in random order to 40 judges comprising 20 prosthodontists and 20 general dentists who were informed about the purpose of the study. Judges first rated the degree of facial naturalness on a visual analog scale (VAS) and then took a discriminatory sensory analysis test (triangle test) where they were required to correctly identify the image with no increase in OVD from a set of three images. Mean VAS ratings for facial naturalness were inversely correlated with incremental increases in OVD, irrespective of the judge's background. Though subjects were rated less natural with incremental increases in OVD, only a 5-mm increase from baseline was clinically significant (P < .05). For the triangle test, judges correctly identified the image with a 3-mm increase in OVD 57% of the time (P < .582), irrespective of the judge's profession, sex, race, and years in practice, which were clinically insignificant. Increasing OVD by a 5-mm opening of the AGP of the articulator significantly decreased the judge's evaluation of facial naturalness. The ratings were more pronounced in female subjects than in male subjects. However, an increase in OVD of 3 mm was visually indistinguishable by the judges.

Temporary increase of occlusal vertical dimension with direct composite using a simplified injection molding technique. Prearrangement for subsequent lab-made restorations

The comprehensive dental rehabilitation of complex prosthetic cases is often associated with increasing occlusal vertical dimension and transferring horizontal mandibular position in centric relation. The newly defined position of the mandibula should be functionally and esthetically evaluated for a longer time period before irreversible measures are performed. This case report discusses in detail a time-saving and economic direct method for increasing occlusal vertical dimension with long-term provisional composite restorations using a simplified injection molding technique and illustrates the complete intraoral and laboratory workflow.

Clinical Considerations while increasing Occlusal Vertical Dimension

ABSTRACTA decrease in occlusal vertical dimension (OVD) may result from tooth structure loss and extraction of posterior teeth, and it affects the esthetics, function, comfort, and lower facial height (LFH). Rehabilitation of patients with worn dentitions may require increase in OVD and interarch distance to create space for restorative materials, improve esthetics, and develop physiologic occlusion. It is usually advisable to assess esthetics, function, LFH, and response of the stomatognathic system to increased OVD by means of removable or fixed provisional appliances before definitive treatment. The following case report presents the multitude of factors considered in planning amount of OVD increase keeping in view its impact on LFH and facial esthetics, during rehabilitation of a patient with severely attrided dentition.How to cite this articlePawar RS, Kulkarni RS, Pimpale SK. Clinical Considerations while increasing Occlusal Vertical Dimension. Int J Prosthodont Restor Dent 2017;7(3):103-107.

Retrospective Study of the Survival and Patient Satisfaction with Composite Dahl Restorations in the Management of Localised Anterior Tooth Wear.

This retrospective study was undertaken to evaluate the clinical performance of direct composite restorations placed at an increased vertical dimension to manage localised anterior tooth wear using the Dahl approach. Two hundred and ninety six restorations were placed at an increased OVD in 41 subjects with localized anterior Tooth Surface Loss (TSL) were included. Survival analysis was carried out at three levels, major failure only, minor failure only and all types of failure. Clinical follow up showed that the posterior occlusion was reformed after a mean duration of 25.4 months (range 6 to 60 months). Mean clinical follow up of 25.4 months showed a success rate of 88.8% and survival rate of 95.6% of the restorations. The major failure rate was 4.4% while the minor failure rate was 8.7%. Patients' reported a significant improvement in appearance, and self-confidence and reduction in sensitivity. Self-reported patient satisfaction with the procedure was high. Placement of resin-based composite restorations at an increased occlusal vertical dimension to manage localised anterior tooth wear has a good short to medium term survival.

咬合挙上および咬合再構成を行ったすれ違い咬合症例

症例の概要：患者は61歳の女性．義歯の破損による咀嚼困難を主訴として来院した．咬合支持は右側犬歯部のみで，咬合高径の分析結果より低位咬合と診断した．咬合挙上および咬合再構成を行ったのち，全残存歯にガイドプレーンを付与し，十分な把持力をそなえた最終補綴装置を装着した． 考察：咬合高径を複数の方法によって検討し適切な高径を付与したこと，すれ違い咬合の状態に対し把持力に配慮した動揺の少ない最終補綴装置を装着したことにより良好な結果をたどっていると考えられる． 結論：咬合挙上および咬合再構成を行い，十分な把持力をそなえた義歯を装着することによって，すれ違い咬合に対応し良好な結果を得ることができた．

Changes in Lower Facial Height and Facial Esthetics with Incremental Increases in Occlusal Vertical Dimension in Dentate Subjects.

To determine if there are objective changes in lower facial height and subjective changes in facial esthetics with incremental increases in occlusal vertical dimension in dentate subjects. Twenty subjects of four different races and both sexes with a Class I dental occlusion had custom diagnostic occlusal prostheses (mandibular overlays) fabricated on casts mounted on a semi-adjustable articulator. The overlays were fabricated at 2-mm, 3-mm, 4-mm, and 5-mm openings of the anterior guide pin of a semi-adjustable articulator. Direct facial measurements were made between pronasale and menton on each subject while wearing the four different overlays. Thereafter, two digital photographs (frontal and profile) were taken for each subject at maximum intercuspation (baseline) and wearing each of the four mandibular overlays. The photographs of eight subjects were standardized and displayed in a random order to 60 judges comprising 30 laypeople, 15 general dentists, and 15 prosthodontists. Using a visual analog scale, each judge was asked to rate the facial esthetics twice for each of the 80 images. For objective changes, although an anterior guide pin-lower facial height relationship of 1:0.63 mm was observed, the findings were not correlated (P>.20). For subjective changes, the visual analog scale ratings of judges were uncorrelated with increases in anterior guide pin opening up to 5 mm, irrespective of the judge's background status or the sexes of the judges or the subjects (P>.80). Incremental increases in anterior guide pin opening up to 5 mm did not correlate to similar increases in lower facial height. Additionally, it made no difference in a judge's evaluation of facial esthetics irrespective of the judge's background status (layperson, general dentist, or prosthodontist) or sex.

AŞIRI DİŞ AŞINMASI OLAN BİR HASTANIN TAM ARK RESTORASYONU VE ISIRMA KUVVETİNİN DEĞERLENDİRİLMESİ: VAKA RAPORU

Aim: The Cleft Lip and Palate (CLP) is variation of a Aesthetic and functional restoration of the severely worn dentiton leads to some challenges due to the insufficient restorative space. In the present case report, 60 years-old male patient had generalized tooth wear, anterior cross-bite, aesthetic problems and impaired masticatory function. After the detailed examination, 2 mm increase of occlusal vertical dimension (OVD) in posterior teeth has been decided. Before treatment, cephalometric radiographs were taken and maximum bite force was measured as 20 kg/kuvvet. Then, for adaptation of patient to the increased OVD, patient used the fixed provisional restoration for 1 month. A second cephalometric radiograph was taken with the provisional restoration at increased OVD. After 1 month, patient did not report any muscle pain or joint discomfort and thus permanent full mouth restoration was completed. One week later of permanent cementation of restorations, patient reported satisfactory masticatory function and at this appointment the bite force was measured as 32 kg/kuvvet

The influence of altered occlusion on pro-inflammatory cytokine levels in the TMJ synovial tissues of rats

ObjectiveThe aim of this study was to evaluate whether altered occlusion affects both the condylar cartilage thickness and the cytokine levels of the TMJs of rats. DesignThirty adult-male rats (n=30) were randomly assigned to three experimental conditions: a control group that underwent sham operations with unaltered occlusion; an FPDM group that underwent functional posterior displacement of the mandible that was induced by an incisor guiding appliance; and an iOVD group in which the increased occlusal vertical dimension was induced in the molars. The rats were subjected to the FPDM or iOVD model for 14 days and then killed. Both the right and left TMJs were removed and randomly assigned to examination with staining or immunoassay techniques. Toluidine blue staining was used to measure the thicknesses of the four layers of the articular cartilage (i.e., the fibrous, proliferating, mature, and hypertrophic layers). ELISA assays were used to assess the concentrations of the pro-inflammatory cytokines IL-1α, IL-1β, IL-6, and tumour necrosis factor (TNF-α). The measurements of the articular cartilage layers and cytokine concentrations were analyzed with ANOVA and Tukey's tests and Kruskal–Wallis and Dunn tests, respectively (α=5%). ResultsThe thickness of articular cartilage in the FPDM group (0.3±0.03mm) was significantly greater than those of the control (0.2±0.01mm) and iOVD (0.25±0.03mm) groups. No significant difference was observed between the control and iOVD groups. The four articular cartilage layers were thicker in the FPDM group than in the control and iOVD groups, and the latter two groups did not differ one from each other. Both the FPDM and iOVD groups exhibited higher cytokine levels than did the control (p<0.05) group. Compared to the FPDM group, the iOVD group exhibited significantly higher levels of IL-1β and TNF-α. ConclusionBoth models induced inflammation in the TMJ and caused significant structural changes in the TMJ and surrounding tissues.

A multidisciplinary approach for the rehabilitation of a patient with an excessively worn dentition: A clinical report

This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient with a severely worn dentition. The treatment included osteotomy and immediate implant placement and loading in the mandible. The definitive restorations were implant- and tooth-supported metal ceramic restorations. These restorations were fabricated with metal occlusal surfaces at an increased occlusal vertical dimension, which provided acceptable esthetics and function.

Information for patients undergoing treatment for toothwear with resin composite restorations placed at an increased occlusal vertical dimension

Toothwear is affecting increasing numbers of the population. In the past, treatment of patients whose teeth were affected by toothwear often involved the reduction of these teeth for crowns; a severe form of toothwear. Contemporary management of such cases is by the bonding of resin composite restorations to the worn and wearing surfaces, with these restorations being placed at an increased occlusal vertical dimension. The advantage of the technique is its minimal- or non-intervention nature and its high reported degree of patient satisfaction. There are, however, short-term disadvantages to the technique, such as the potential for lisping, pain from the teeth which will be subject to axial orthodontic tooth movement, and difficulty in chewing on the posterior teeth if these are discluded. It is therefore important, as with any treatment, that the advantages and disadvantages are fully explained to the patient. This paper therefore describes the clinical technique and presents a Patient Information Leaflet that the author has used for over five years. Patients should be advised regarding the disadvantages and advantages of any technique.

Dental Considerations in the Adjustment of Lost Occlusal Vertical Dimension: A Clinical Report

The purpose of this clinical report is to discuss the clinical considerations related to increasing the occlusal vertical dimension (OVD) when restoring a patient’s dentition. Extra-oral and intraoral evaluations are mandatory to assess the suitability of increasing OVD. In the literature, multiple techniques have been proposed to quantify OVD loss. However, the techniques lack consistency and reliability, which in turn affects the decision of whether to increase the OVD. Therefore, increasing OVD should be determined on the basis of the dental restorative needs and aesthetic demands. In general, a minimal increase in OVD should be applied, through a 5 mm maximum increase in OVD can be justified to provide adequate occlusal space for the restorative material and to improve anterior teeth aesthetics. The literature reflects the safety of increasing the OVD permanently, and although signs and symptoms may develop, these are usually of an interim nature. The exception to this is for patients with Temporo-mandibular joint disorder (TMD), where increasing the OVD should still be achieved using removable appliances to control TMDassociated symptoms before considering any form of irreversible procedures.

Effect of Patient's Personality on Satisfaction with Their Present Complete Denture and after Increasing the Occlusal Vertical Dimension: A Study of Edentulous Egyptian Patients.

Complete denture wearers often find it difficult to accept a new denture. Personality traits are among the factors that possibly affect patient satisfaction with a complete denture. Our aim was to investigate the influence of patients' personality on satisfaction with their present denture and after an increase in the occlusal vertical dimension (OVD). Sixty edentulous patients with complete dentures (22 men and 38 women, mean age 66 years, and range 50–75 years) participated in the study. The age of their complete dentures ranged from 5 to 16 years. Patients' personalities were evaluated using the Arabic version of the Eysenck Personality Questionnaire. Their satisfaction with their dentures before and after restoration of the OVD and relining of the mandibular denture was evaluated using two questionnaires (I and II), Patients with a high score of neuroticism were less satisfied with their original dentures and after relining and an increase of OVD compared with patients with an average score in that trait. The personality trait of psychoticism was significant to patients' acceptance of an increase in OVD; that is, patients with a high score were less satisfied with their dentures after increase of OVD than patients with an average score. It is concluded that personality traits affect patients' acceptance of their complete dentures.

Full mouth rehabilitation in a patient with loss of vertical dimension caused by severe tooth loss: a case report

Decrease of occlusal vertical dimension (OVD) due to loss of teeth structure and destruction of the occlusal plane by severely worn dentition may cause cross bite or temporomandibular joint disorder by following change of facial feature or the loss of anterior guidance. Full mouth rehabilitation via an increase of the OVD can be considered to avoid this problem and proper evaluation of patient's OVD is essential. An 80 year old male visited for overall prosthodontic treatment, cross bite due to continuous wear and following decrease of the OVD were observed. We analyzed the existing occlusal relationship using the diagnostic cast, the radiographic evaluation and clinical test, and then proper increase of OVD was selected. The new OVD on diagnostic wax up was placed by the temporary restoration. After 3 months of observation period, final restoration with fixed partial dentures and implant overdenture were made. Throughout the follow-up period of 8 months, the aesthetic and functional improvement can be obtained. (J Korean Acad Prosthodont 2014;52:42-7)