Increase In Vertical Dimension Research Articles

Clinical performance of full rehabilitations with direct composite in severe tooth wear patients: 3.5 Years results

ObjectivesTo evaluate the mid-term clinical performance of direct composite restorations placed in patients with pathological tooth wear needing full rehabilitation with an increase of vertical dimension of occlusion. MethodsIn a prospective trial 34 patients (34.0 ± 8.4 years; 25 males, 9 females) were treated with a minimal invasive additive technique using composite restorations. The restorative treatment protocol was to provide all teeth with composite build-up restorations in an increased vertical dimension of occlusion (VDO) using the DSO-technique. Recall appointments were planned after 1 month, 1 and 3 years after treatment. Restorations were scored for clinically acceptability (FDI-criteria) and scores 4 and 5 were recorded as clinically unacceptable. Frequencies of failures and Kaplan Meier survival curves are presented and effect of relevant variables was calculated with a multifactorial Cox regression (p < 0.05). Results1256 Restorations were placed, 687 anterior, 324 premolar, and 245 molar restorations. After a mean observation time of 39.7 months a total of 69 failures were observed, of which 61 restorations were repaired (score 4) and 8 were replaced (score 5). Most common reasons for failure were (chip) fractures (n = 43) and caries (n = 11). Placement of anterior restorations in two sessions led to significant 4.6 times more failures then placed in one session. ConclusionsIn patients with severe tooth wear a full rehabilitation, in an increased vertical dimension of occlusion, direct composite resin restorations show a 94.8% success and 99.3% survival rate after a period of 3.5 years.

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

Prosthodontic treatment of an Angle III Class malocclusion: A case report.

Patients with an Angle Class III malocclusion are generally treated by orthodontics with or without orthognathic surgery. A literature search revealed very few articles describing solely the prosthodontic treatment of a Class III malocclusion, as it is rarely used as a treatment modality in these cases. The purpose of this article is to show the effects and benefits of an increase in the vertical dimension of the occlusion (VDO) in patients with a Class III malocclusion. An increase in the VDO causes a clockwise rotation of the mandible, thereby increasing the reverse overjet. This phenomenon allows a prosthodontic treatment of the Class III malocclusion in some patients. Therefore, proper diagnostic procedures, careful planning, and a simulation of the final appearance by wax-up and mock-up are mandatory when choosing the modality of prosthodontic treatment. A case with a Class III malocclusion, treated solely by prosthodontic means, is presented. The implemented prosthodontic treatment included the correction of the crossbite and the occlusal plane, the reestablishment of the anterior and canine guidance as well as the provision of a stable occlusion and enhanced facial and dental esthetics. It is proposed that an increase of the VDO should be taken into consideration whenever a patient with a Class III malocclusion is prosthodontically treated.

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.

Time-course changes of the mandibular position after mandibular setback surgery in surgery-first approach depending on the increase of vertical dimension and amount of mandibular setback

Time-course changes of the mandibular position after mandibular setback surgery in surgery-first approach depending on the increase of vertical dimension and amount of mandibular setback

Evaluation of Three Different Processing Techniques in the Fabrication of Complete Dentures.

Aims and Objectives:The objective of the present study is to compare the effectiveness of three different processing techniques and to find out the accuracy of processing techniques through number of occlusal interferences and increase in vertical dimension after denture processing.Materials and Methods:A cross-sectional study was conducted on a sample of 18 patients indicated for complete denture fabrication was selected for the study and they were divided into three subgroups. Three processing techniques, compression molding and injection molding using prepolymerized resin and unpolymerized resin, were used to fabricate dentures for each of the groups. After processing, laboratory-remounted dentures were evaluated for number of occlusal interferences in centric and eccentric relations and change in vertical dimension through vertical pin rise in articulator. Data were analyzed using statistical test ANOVA and SPSS software version 19.0 by IBM was used.Results:Data obtained from three groups were subjected to one-way ANOVA test. After ANOVA test, results with significant variations were subjected to post hoc test. Number of occlusal interferences with compression molding technique was reported to be more in both centric and eccentric positions as compared to the two injection molding techniques with statistical significance in centric, protrusive, right lateral nonworking, and left lateral working positions (P < 0.05). Mean vertical pin rise (0.52 mm) was reported to more in compression molding technique as compared to injection molding techniques, which is statistically significant (P < 0.001).Conclusions:Within the limitations of this study, injection molding techniques exhibited less processing errors as compared to compression molding technique with statistical significance. There was no statistically significant difference in processing errors reported within two injection molding systems.

Full mouth rehabilitation with vertical dimension increase in patient with loss of anterior guidance due to maxillary anterior teeth wear: A case report

Full mouth rehabilitation with vertical dimension increase in patient with loss of anterior guidance due to maxillary anterior teeth wear: A case report

Effect of premolar extractions on facial vertical dimension- A cephalometric study

Background: The purpose of this study was to compare changes in the facial vertical dimension in patients after the extraction of maxillary and mandibular premolars. Materials and methods: The pre and post treatment records of 20 patients of age range 18-25 years who had skeletal class II with hyperdivergent facial form and have undergone maxillary and mandibular first premolar extractions for orthodontic treatment under Roth prescription were taken. Results: There was significant increase seen in the maxillo-mandibular plane (MM angle) and Steiner’s SN (Go-Gn) angle of pre and post treatment cephalometric records. Conclusion: The results of this study showed that stress should be given on incisor intrusion and extrusion of molars should be avoided to prevent further increase in vertical dimensions in vertical growers. Keywords: Vertical dimension, Premolar extractions

Etiology, classification and systematic restorative treatment of tooth wear

Tooth wear has complex and multi-factorial etiologies that result in the surface loss of dental hard tissues. Clinic prevention and restorative technology of tooth wear are challenge for dentists with the increasing numbers of population and the transition of disease age. From the etiology and classification of tooth wear, it is crucial to accurately assess and diagnose a patient presenting with tooth wear. Fluoride application, sealant and resin bonded restoration are beneficial to manage the mild tooth wear. For severe tooth wear, it is need to fabricate the diagnostic wax-up, and resin mock-up is also used to verify the occlusal relationship and vertical dimension increase, and then an interim restoration is also used to adapt the patient to the change of occlusion. Finally, by means of contemporary adhesive technique and min-invasive treatment, the dentist can reconstruct the shape of worn tooth, effectively restore the function of chewing and improve the appearance and pronounciation.

Postoperative changes in mandibular position after mandibular setback surgery via the surgery-first approach in relation to the increase of vertical dimension and the amount of mandibular setback

This study aimed to compare preoperatively predicted rotational relapse with actual post-treatment mandibular position after mandibular setback surgery via the surgery-first approach and to evaluate the effect of the increase of vertical dimension (VD) on surgical occlusion and the amount of mandibular setback on postoperative mandibular positional changes. Twenty-nine patients who underwent bilateral sagittal split ramus osteotomy for mandibular prognathism were evaluated by using lateral cephalograms, which had been obtained preoperatively, immediately postoperatively, and immediately after debonding. Increase of VD on surgical occlusion was measured preoperatively. We estimated the mandibular forward movement resulting from the postoperative mandibular anticlockwise rotation during postoperative orthodontic treatment and compared it with the actual post-treatment mandibular position. The actual postoperative mandibular forward movement (2.1mm) was significantly greater compared with the forward movement (1mm) predicted preoperatively (P<.01). The postoperative mandibular forward movement was greater in the groups with greater VD increase (>1.5mm) or greater mandibular setback (>10mm), even though there was no statistically significant difference. These results suggest that additional postoperative relapse may occur with mandibular rotational relapse, and VD increase and the amount of mandibular setback may affect post-treatment mandibular position in surgery-first orthodontic treatment.

Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition

Severe tooth wear may cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance, pathogenic pulp and occlusal disharmony. Treating patients with severely worn dentition often requires full mouth rehabilitation with increasing vertical dimension. Proper diagnosis and treatment planning are important for esthetic and functional definitive restorations and the long term stability of the neuromuscular system and the TMJ. In this case, 66 year-old female presented with generalized worn dentition. Based on assessment, pathologic destruction of teeth structure on entire dentition was caused by masticatory force and diet habit without loss of vertical dimension. Subsequently, 3 mm increase of vertical dimension that based on incisor for tooth restoration and esthetic improvement was determined. After 8 weeks stabilization period with temporary fixed prostheses, definitive prostheses were fabricated. After 6 months follow up period, satisfactory outcomes were attained both functional and esthetic aspects through this procedure.

3D Facial Effects of a Simulated Dental Build-up.

The purpose of this study was to evaluate the 3D-stereophotogrammetry technique to detect differences in facial appearance after a simulated rehabilitation. Eleven volunteers without tooth wear participated. A 3D-stereophotograph was taken in five different situations: resting position, teeth in occlusion, and teeth in occlusion with a 1 mm-, 3 mm- or 5 mm resin block between the first molars. Cephalometric measurements were performed on the 3D-stereophotographs using the software program Maxilim® (Medicim NV Mechelen, Belgium). Four anatomical parameters were analyzed: (1) Subnasale-Gnathion, (2) Subnasale-Stomion, (3) Stomion-Gnathion, and (4) Masseter right-Masseter left. A paired Student's T-test was applied to detect significant differences (p < 0.05). Statistically significant changes in facial appearance of the lower facial height were detected in all measured positions, teeth in occlusion, 1 mm-, 3 mm-, and 5 mm block (p < 0.05). For the main distance (Subnasale-Gnathion) the mean measured differences were, respectively, 3.2 mm; 5.2 mm; and 6.7 mm. With 3D-stereophotograph imaging technology, it was possible to detect changes in facial appearance after an artificial increase of vertical dimension of occlusion. This finding implies that reconstruction of loss of tooth substance may cause a visible change in facial appearance of the patient. This study reveals a new 3D imaging technique that may be used for a better and more comprehensive treatment planning in patients with severe tooth wear. (J Esthet Restor Dent 28:397-404, 2016).

EFFECT OF OCCLUSAL VERTICAL DIMENSION OF COMPLETE DENTURE ON MAXIMUM BITING FORCE

Ten completely edentulous male patients; ranging in age from 45 to 50 years, were selected to study the effect of changing the vertical dimension of occlusion of complete denture wearers on the maximum biting force. For each patient five heat cured acrylic resin record blocks were constructed with different vertical dimensions. Bilateral seats in the premolar area were prepared within the occlusion rim to accommodate for the load cell used in biting measurement. The height of the load cell was 8 mm while the seats were prepared to be one mm less than the height of the load cell to facilitate the registration of the biting force. The base of the seat was prepared parallel to the occlusal plane. The biting force measurements were done by the record blocks with different vertical dimensions unilaterally (right side then left side measurements). The results of this study showed the values of biting forces upon changing the vertical dimension of occlusion in the right and left sides. When the vertical dimension of occlusion increased 3 mm there was an increase in the maximum biting force, while when the vertical dimension of occlusion increased 6 mm; the maximum biting force was decreased than that values obtained by 3 mm increase in vertical dimension. On the other hand when the vertical dimension of occlusion was decreased by 3 mm and 6 mm, the maximum biting force was decreased. The results of the present study concluded that the vertical dimension of occlusion is not an optimal vertical dimension that produces the maximum biting forces.

Effect of placing intentionally high restorations: Randomized clinical trial

ObjectiveThe aim of this study was to examine the behavior of posterior teeth restored with single-tooth restorations with intentionally high occlusal contacts. MethodsConsent was obtained from 17 patients who were seen a total of 5 times over 3.5 years. The restorations placed were all full occlusal coverage gold restorations. Tooth mobility was recorded using the Periotest device and tooth movement was determined from impressions and 3D imaging. Patients were randomly assigned into two groups, the control group which received restorations with no intentional increase of the occlusal vertical dimension; or the treatment group where they received intentionally high restorations in 0.5mm supraocclusion. ResultsStatistical analysis showed no significant difference in mobility between visits for both the control and the treatment groups while a significant dependency and difference in tooth movement was observed between the subjects of the two groups. Most patients from the treatment group reported discomfort but no pain for the first 7–10 days after the restoration was fitted, which subsided over a period of couple of weeks. At review, 3 years later, no mobility or additional movement was observed. ConclusionsCementation of an intentionally high single-tooth restoration causes no increase in tooth mobility while occlusal adaptation re-establishes and restores the occlusal plane.

Correction of a Class II Occlusion in an Adult

Introduction: Mandibular advancement and vertical correction with extrusion are two basic procedures that permit the skilled orthodontist to re-posture the mandible in Class II deep-bite occlusion with a disto-positioned mandible. Aim: To verify the entity and the possibility of mandibular advancement in a non growing deep-bite patient while improving vertical dimension. Methods: The diagnostic procedure is based on the use of (TENS) (Trans-cutaneous Electrical Nerve Stimulator) with application of the basic principles as described with the Neuromuscular Theory and technique. Treatment of a Class II occlusion on an adult patient without the use of mandibular tracking devices and without the aid of electromyography is described. Results: Mandibular advancement and increase in vertical dimension were achieved. Flaring of lower incisors and head extension improved overall aesthetics. Conclusions: The use of TENS is a valid diagnostic aid for predicting mandibular advancement in the adult patient.

The survival of direct composite restorations in the management of severe tooth wear including attrition and erosion: A prospective 8-year study

ObjectivesSurvival of directly placed composite to restore worn teeth has been reported in studies with small sample sizes, short observation periods and different materials. This study aimed to estimate survival for a hybrid composite placed by one clinician up to 8-years follow-up. MethodsAll patients were referred and recruited for a prospective observational cohort study. One composite was used: Spectrum® (DentsplyDeTrey). Most restorations were placed on the maxillary anterior teeth using a Dahl approach. ResultsA total of 1010 direct composites were placed in 164 patients. Mean follow-up time was 33.8 months (s.d. 27.7). 71 of 1010 restorations failed during follow-up. The estimated failure rate in the first year was 5.4% (95% CI 3.7–7.0%). Time to failure was significantly greater in older subjects (p=0.005) and when a lack of posterior support was present (p=0.003). Bruxism and an increase in the occlusal vertical dimension were not associated with failure. The proportion of failures was greater in patients with a Class 3 or edge-to-edge incisal relationship than in Class 1 and Class 2 cases but this was not statistically significant. More failures occurred in the lower arch (9.6%) compared to the upper arch (6%) with the largest number of composites having been placed on the maxillary incisors (n=519). ConclusionThe worn dentition presents a restorative challenge but composite is an appropriate restorative material. Clinical significanceThis study shows that posterior occlusal support is necessary to optimise survival.

A full-mouth rehabilitation using zirconia all-ceramic crowns: a case report

As patients' esthetic expectations increase, there is an increase in demand for cosmetic restorations of anterior and posterior teeth that resemble the natural tooth morphology and color. An example of high-strength all-ceramic systems is zirconia with CAD/CAM application. This case report describes a full-mouth rehabilitation using zirconia all-ceramic crowns supported by upper and lower implants and by a minimal increase in the occlusal vertical dimension in a patient with severe abrasion due to loss of posterior teeth.

Real-time imaging of anti-biofilm effects using CP-OCT.

The objective of this study was to develop a method to reliably and reproducibly assess the physical properties of in vitro multi-species plaque derived biofilms. A custom flow cell (FC) was designed to model oral cavity shear stresses on biofilms grown on hydroxyapatite (HA) discs. A finite-element program (ANSYS 13) modeled flow velocities and wall shear stresses on the interior 3D dimensions. For the experiment, 1% chlorhexidine (CHX), 5 M urea, and a 1× phosphate-buffered saline (PBS) were flown through the FC simulating oral rinsing. Near infrared cross-polarization optical coherence tomography (CP-OCT) non-destructively imaged the fluid immersed biofilms in real time (20 frames/s). During low flow, the swell of the biofilm caused from 5 M urea was quite pronounced increase in vertical dimension. Biofilms exposed to 1% CHX showed a slight collapse in the vertical dimension of the biofilm during low flow. During high flow/high sheer stress, the 5 M urea solution effectively removed the biofilm, while both 1% CHX and 1× PBS did not remove biofilms even under high velocity/shear stress conditions.