Increase In Vertical Dimension Research Articles

Evaluation of condylar and mandibular movements on the upper airway during the use of mandibular advancement device for obstructive sleep apnea treatment.

To evaluate the temporomandibular joint (TMJ), condylar and mandibular movements in obstructive sleep apnea (OSA) patients treated with mandibular advancement device (MAD) and to identify the influence of these anatomic factors on upper airway (UA) volume and polysomnographic outcomes after treatment. Twenty OSA patients were prospectively treated with MAD. Clinical examinations, cone-beam computed tomography, and polysomnography were performed before MAD treatment and after achieving therapeutic protrusion. Polysomnographic variables and three-dimensional measurements of the TMJ, mandible, and upper airway were statistically analyzed. Condylar rotation, anterior translation, and anterior mandibular displacement were directly correlated with total UA volume, while vertical mandibular translation was inversely correlated with the volume of the inferior oropharynx. MAD treatment resulted in an increase in the volume and area of the superior oropharynx. There was no statistically significant correlation between condylar rotation and translation and polysomnographic variables. With MAD, there was a significant increase in vertical dimension, changes in condylar position (rotation and translation), and mandibular displacement. The central and medial lengths of the articular eminence were inversely correlated with condylar rotation and translation, respectively. The lateral length of the eminence was directly correlated with condylar translation, and the lateral height was directly correlated with condylar rotation and translation. Condylar and mandibular movements influenced UA volume. The articular eminence played a role in the amount of condylar rotation and translation. Individualized anatomical evaluation of the TMJ proves to be important in the therapy of OSA with MAD.

Full mouth rehabilitation with vertical dimension increase in patient with excessive worn dentition due to parafunctional mandibular movements: a case report

Full mouth rehabilitation with vertical dimension increase in patient with excessive worn dentition due to parafunctional mandibular movements: a case report

A case report of improvement in stability of dentures and lip support by increase of occlusal vertical dimension

A case report of improvement in stability of dentures and lip support by increase of occlusal vertical dimension

Vertical effects of cervical headgear in growing patients with Class II malocclusion: a systematic review and meta-analysis.

Cervical headgear (cHG) has been shown to be effective in Class II correction both with dental and orthopaedic effects but has traditionally been associated with vertical adverse effects in terms of posterior mandibular rotation. To assess the treatment effects of cHG treatment in the vertical dimension. Unrestricted literature search of five databases up to May 2023. Randomized/non-randomized clinical studies comparing cHG to untreated controls, high-pull headgear (hp-HG), cHG adjuncts, or other Class II treatment alternatives (functional appliances or distalisers). After duplicate study selection, data extraction, and risk-of-bias assessment according to Cochrane, random-effects meta-analyses of mean differences (MD)/standardized mean diffences (SMD) and their 95% confidence intervals (CIs) were performed, followed by meta-regressions, sensitivity analyses, and assessment of certainty on existed evidence. Two randomized/16 non-randomized studies (12 retrospective/4 prospective) involving 1094 patients (mean age 10.9 years and 46% male) were included. Compared to natural growth, cHG treatment was not associated on average with increases in mandibular (eight studies; SMD 0.22; 95% CI -0.06, 0.49; P = 0.11) or maxillary plane angle (seven studies; SMD 0.81; 95% CI -0.34, 1.95; P=0.14). Observed changes translate to MDs of 0.48° (95% CI -0.13, 1.07°) and 1.22° (95% CI -0.51, 2.94°) in the SN-ML and SN-NL angles, respectively. No significant differences were seen in y-axis, facial axis angle, or posterior face height (P > 0.05). Similarly, no significant differences were found between cHG treatment and (i) addition of a lower utility arch, (ii) hp-HG treatment, and (iii) removable functional appliance treatment (P > 0.05 for all). Meta-regressions of patient age, sex, or duration and sensitivity analyses showed relative robustness, while our confidence in these estimates was low to very low due to the risk of bias, inconsistency, and imprecision. cHG on average is not consistently associated with posterior rotation of the jaws or a consistent increase in vertical facial dimensions among Class II patients. PROSPERO registration (CRD42022374603).

New anterior guidance induction through spontaneous gap closure after an increase in vertical dimension: a case report

New anterior guidance induction through spontaneous gap closure after an increase in vertical dimension: a case report

Rehabilitation with minimal increase in occlusal vertical dimension in a patient with excessive tooth wear and edge-to-edge bite

Rehabilitation with minimal increase in occlusal vertical dimension in a patient with excessive tooth wear and edge-to-edge bite

Fabrication of complete denture using CAD-based vertical dimension increase and monolithic disc: a case report

Fabrication of complete denture using CAD-based vertical dimension increase and monolithic disc: a case report

Functional orthopedic device type Sn20 – a therapeutic resource in the control of chronic temporomandibular dysfunction – case report

The literature indicates that patients with a history of Temporomandibular Disorder (TMD), who experience sudden occlusal changes, may worsen their parafunctional habits and develop TMD again. In this sense, the aim of this study is to present a clinical case of recurrent chronic TMD after oral rehabilitation (increase of vertical dimension in all teeth) using Simões Network 20 (SN20) functional orthopedic appliance as one of the resources therapies. The patient was female, 62 years old, and complained of disabling pain, anxiety symptoms, hypervigilant and history of TMD. The patient reported failure of other treatment modalities, including use of the smooth stabilizer device. The diagnosis was chronic TMD – primary osteoarthritis of the temporomandibular joint and related myofascial pain and orofacial migraine. Treatment included physical measurements, instructions, peripheral and central medication, AOF type SN20 (night use). After three months of therapy, the patient showed significant improvement with complete pain reduction. The use of the AOF SN20 together with conservative measures represents a valuable therapeutic modality for patients with chronic TMD.

Complete oral rehabilitation with direct and indirect composite resins: a minimally invasive approach on severely compromised teeth.

The rehabilitation of severely worn teeth is a complex challenge for dental practitioners. There are many different types of dental materials and restorative techniques, and there is not a single way to achieve the desired result. This clinical report demonstrates a complete oral rehabilitation with composite resins when using an indirect application and direct techniques, with the support of the Lucia Jig technique, the Willis technique, and diagnostic waxing for the vertical dimension correction. The wide clinical improvement was achieved with the recovery of the function, the esthetics, and the increase of vertical dimension of occlusion through the planned treatment. The proposed treatment maintained the natural teeth, without the intense wear by the application of the composite resins instead of ceramics, together with excellent conditions for the patient to control the posttreatment and extend the durability, with the correct follow-up of appointments. Young patients with extensive dental wear and the loss of vertical dimension should not be directly submitted to ceramic treatments, with preparations for full crowns. Oral rehabilitation using composite resins, either directly or indirectly, allows for the recovery of the function and esthetics, without the intense predictable dental wear, and reduced financial investment.

Vertical Skeletal Changes after Extraction and Nonextraction Orthodontic Treatment.

Due to the constant battle regarding the controversial topic of orthodontic extraction, this study aims to assess the changes in vertical dimensions of patients treated with premolar extractions compared with nonextraction orthodontic patients. A sample of 60 borderline patients were recruited and divided into extraction and nonextraction groups. Eleven pretreatment cephalometric measurements were recorded using WebCeph and patients were followed-up until the completion of treatment. Intragroup and intergroup comparisons were made using paired t-test and two-sample independent t-test, respectively. The joint significance of differences was measured using F-tests. The intragroup comparison revealed that in the extraction group, the vertical dimension was significantly increased posttreatment for four cephalometric measurements, that is, mandibular plane angle (p < 0.05), palatal plane angle (p < 0.05), Frankfort mandibular plane angle (p < 0.05), and y-axis (p < 0.05). In the comparison of the posttreatment values of both groups, the mean differences of the posttreatment values for sella nasion (SN)-gonion (Go)-gnathion (Gn) angle (p = 0.008), the total anterior (p = 0.050), and lower anterior facial heights (AFH; p = 0.011) were significantly higher. At the same time, the Jarabak ratio was significantly (p = 0.006) lower in the extraction group than in the nonextraction group. The increase in vertical dimension is significantly higher in the extraction group than in the nonextraction group which indicates a significant impact of orthodontic extraction on the vertical dimensions.

Evaluation of mandibular positional changes after orthognathic surgery in skeletal class II and class III surgery-first approach patients

PurposeThe aim of this study was to predict and compare postoperative changes of mandibular position between mandibular setback and advancement surgery in a surgery-first approach (SFA). Materials and methodsThe study population included patients who underwent mandibular setback or advancement surgery using bilateral sagittal split ramus osteotomy, those were divided into two groups: mandibular setback and advancement surgery. Surgical and postoperative mandibular positional changes were evaluated by lateral cephalograms and CTs taken within 2 months before surgery (T0), 1 week after surgery (T1), and after the debonding procedure (T2). The postoperative mandibular positional changes were predicted from the increase in vertical dimension (VD) in surgical occlusion and the counterclockwise rotation to the preoperative VD on the lateral cephalograms and CT at T1. Furthermore, resultant measurement on postoperative mandibular positional changes was performed. Finally, we compared the prediction with actual positional changes of the mandible after the debonding procedure. ResultsNine SFA patients with mandibular setback surgery and six with advancement surgery were evaluated and significant mandibular changes from T0 to T1 and from T1 to T2 were observed. Negative correlation between horizontal surgical changes and postoperative horizontal changes was present in both groups. The difference between the predicted and actual amount of postoperative mandibular movement was significant in the mandibular advancement surgery group. ConclusionPostoperative mandibular relapse appeared much larger in the mandibular advancement surgery group than in the setback group. Therefore, it is more important to consider the postoperative mandibular position change in mandibular advancement surgery in SFA.

A comparison of virtually mounted dental casts from traditional facebow records, average values, and 3D facial scans

Statement of problemAlthough average values and facebow records have been incorporated into prosthetic dentistry with much success, little is known about how using 3D facial scans for mounting compare with traditional mounting methods. PurposeThe purpose of this pilot clinical study was to determine differences in measurements among casts mounted virtually by using the average values of the Bonwill triangle and the Balkwill angle, casts mounted by using facebow records, and casts mounted from 3D facial scans. Material and methodsIntraoral digital scans were obtained from each participant (n=10) and 3D printed in resin. For the facebow preservation group (FPG), a facebow record was used to mount the resin casts on a semiadjustable articulator. A desktop scanner was used to digitize this mounting while preserving the facebow record. The average mounting group (AMG) consisted of intraoral digital scans that were mounted virtually by using the concepts of the Bonwill triangle and the Balkwill angle. For the facial scan group (FSG), the participants’ digitized casts were superimposed on the facial scans by using a target system. The Bergstrom point and the glabella were used to mount these casts and their associated facial scans in the digital environment. This study used the FPG as the group to compare with the other mounting techniques because of its wide acceptance in restorative dentistry. These virtual mountings were completed in a computer-aided design software program, and the distance from right and left condylar elements to the incisal embrasure between mandibular central incisors, distance from left mandibular first molar to left condylar element and from right mandibular first molar to right condylar element, and anterior and posterior recordings at 0 mm, 3 mm, and 5 mm of vertical dimension increase were recorded. A Kruskal-Wallis 1-way analysis of variance was performed (α=.05). The Mann-Whitney U test was performed to evaluate differences in measured values among groups, and multiple comparisons were adjusted by using Bonferroni correction. ResultsAll anterior and posterior measurements to the condylar elements of the virtual articulator were found to be significantly different (P<.05). Both anterior and posterior condylar measurements between the FPG and the AMG were found to be significantly different (P<.05), while comparisons between the FPG and the FSG were found not to be significantly different (P>.05). All changes in vertical dimension were found not to be significantly different with respect to both anterior and posterior measurements (P>.05). ConclusionsWhen used to virtually mount dental casts, 3D facial scanners performed similarly to traditional facebow records.

True vertical changes in patients with skeletal class III malocclusion after nonsurgical orthodontic treatment—a retrospective study comparing different vertical facial patterns

Background/purposeRotating mandible backward downward is one of the treatment options in non-surgical skeletal class III malocclusion. The purpose of this study was to compare the true vertical changes after camouflage orthodontic treatment of adult patients with skeletal class III malocclusion categorized by vertical facial type. Materials and methodsThis retrospective study included 27 adult patients (age >18 years) with skeletal class III malocclusion (ANB<1°) who underwent nonsurgical orthodontic treatment at Taipei Veterans General Hospital. The patients were divided into the low-angle (SN-MP<28°), high-angle (SN-MP>36°), and normal-angle (28°≤ SN-MP ≤ 36°) groups according to the original vertical facial pattern. Pretreatment (T1) and post-treatment (T2) lateral cephalograms were superimposed and treatment changes were evaluated. ResultsIn all cases, proper overjet and occlusion were achieved after treatment, and the lower anterior facial height increased with the backward rotation of the mandibular plane. Increase in vertical dimension was the most obvious in the high-angle group, while it was the least obvious in the low-angle group. Extrusion of both the maxillary and mandibular incisors was observed in the high-angle group; however, intrusion of the maxillary and mandibular incisors and decreased overbite were observed in the low-angle group. ConclusionCamouflage orthodontic treatment of skeletal class III malocclusion improves the facial profile by increasing the vertical dimension and clockwise rotation of the mandible. According to our results, patients with a high mandibular plane angle showed better response to vertical dimension increment treatment mechanics than those with low and normal mandibular plane angles.

Treatment of Class II Malocclusion With Removable Functional Appliances: A Narrative Review

AbstractAround half of all malocclusions that need orthodontic treatment are Class II in nature. Patients with Class II malocclusion primarily seek treatment for aesthetic improvement. Most of the skeletal class II malocclusions are because of mandibular deficiency, and can be best treated during the growing phase of development by removable functional appliances. The objective of this review is to evaluate and compare skeletal and dentoalveolar effects of various removable functional appliances in the treatment of class II malocclusion. Manual and electronic databases were searched, and out of 5,711 articles, 221 abstracts were shortlisted and reviewed. A total of 19 articles that fulfilled the selection criteria was then retrieved and analyzed. A significant increase in mandibular length and dentoalveolar effects with an increase in vertical dimension in a short time was observed with Twin-Block appliance treatment, followed by Bionator appliance treatment. The long-term stability of results achieved with Twin-Block appliance treatment is still questionable. In addition, Frankel appliance treatment effects are more skeletal in nature, with better control in the vertical dimension. However, it takes a more extended treatment duration to produce similar effects. Based on available evidence, we are convinced that removable functional appliances are valuable tools for correction of the Class II malocclusion at a growing age with a horizontal growth pattern.

Personalized Orthodontics: From the Sagittal Position of Lower Incisors to the Facial Profile Esthetics.

Background: One of the goals of orthodontic treatment is to obtain maximum facial harmony. The sagittal position of the lower incisors plays a significant role in the planning of orthodontic treatment. The aim of the study was to evaluate the relationship between the sagittal position of lower incisors and facial profile esthetics with reference to the skeletal vertical dimension. Methods: There were 200 patients included in the study. Patients were allocated into three groups, depending on the vertical growth pattern: normal-angle, low-angle, and high-angle cases. Tweed–Merrifield cephalometric analysis was used to assess the sagittal and vertical position of the mandible, as well as to assess the sagittal position of the lower incisors. Results: Z-angle and Frankfort mandibular incisor plane angle (FMIA) decreased significantly (p < 0.001) with the increase of the skeletal vertical dimension. Incisor mandibular plane angle (IMPA) was significantly higher (p < 0.001) in low-angle patients compared to the high-angle ones. Z-angle appeared to be the most accurate parameter (area under curve, AUC = 0.957) describing patients with a convex profile. The cutoff value of Z-angle 68.0° was characterized by the sensitivity of 94.1% and the specificity of 84.3%. Conclusions: The sagittal position of the lower incisors significantly affects the facial profile convexity. The Z-angle is the parameter which most accurately describes the patients with a convex profile.

Effect of short-term increase in occlusal vertical dimension on masticatory muscle electrical activities and pressure-to-pain threshold: A crossover clinical study

Statement of problemIncreasing the occlusal vertical dimension (OVD) is a common procedure in clinical practice. However, few studies have assessed the short-term influence of an increased OVD on the masticatory muscles. PurposeThe purpose of this crossover clinical study was to investigate the effect of increased OVD on the electrical activity of masticatory muscles and the pressure-to-pain threshold (PPT) in asymptomatic participants. Material and methodsTwenty asymptomatic participants (22.7 ±2.39 years of age; 10 men, 10 women) were submitted to an increase in OVD by using interocclusal devices of different thicknesses (3- and 6-mm) for 24 hours. Masticatory muscle activity was assessed with electromyography (EMG), expressed in microvolts (μV), while the participants masticated 2 pieces of latex of different consistency (latex S and H) with and without the device. The PPT was measured with a digital algometer before and after the mastication. The results were assessed by using analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test (α=.05). ResultsThe change of OVD did not significantly affect the electrical activity of the muscles. The latex of hard consistency (latex H) showed higher electrical activity values than the soft texture (latex S). For the working side anterior temporal muscle, a change in the PPT was detected on the day the 6-mm-device was inserted, but for the other muscles, device thickness and latex mastication did not change the PPT. ConclusionsFor a short time, an increase in occlusal vertical dimension did not affect the electrical activity in the masticatory muscles or pressure-to-pain threshold in asymptomatic participants.

Full mouth rehabilitation with vertical dimension increase in patient with severly worn dentition

Full mouth rehabilitation with vertical dimension increase in patient with severly worn dentition

Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition: A case report

Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition: A case report

Rehabilitation of a Severely Worn Dentition with Partial Lithium-disilicate Glass Ceramic Restorations: A Case Report

Rehabilitation of worn dentition is a challenging task because several predisposing factors may be included in the pathogenesis. The treatment options and process should be carefully considered based on the clinical condition and patients’ requirements. This case report represents the esthetic rehabilitation of a 68-year-old patient who exhibited severely worn teeth caused by attrition and erosion. After clinical evaluation, 3 mm increase in occlusal vertical dimension was planned with partial lithium-disilicate ceramic restorations as laminate veneers for anterior teeth and vonlays (onlays with veneer extentions) for posterior teeth in maxilla. The adaptation of the patient to the increased occlusal vertical dimension was tested for 1 month by provisional direct composite restorations. As the patient did not show any discomfort, definitive restorations were completed. The patient was satisfied with the esthetics and functionality of her new dentition.

Correlation of Patient Satisfaction with Treatment Duration in Tooth Supported Full Mouth Rehabilitation Cases: A Retrospective Study

Full mouth rehabilitation is a comprehensive treatment and hence requires a longer duration along with patient co-operation and operator skill. Data of 86000 patients between June 2019 and March 2020 was reviewed from the patient's records and analysed that was documented in Saveetha Dental College and Hospital, Chennai, India. 152 patients who underwent tooth supported full mouth rehabilitation were included in this retrospective study. The data regarding the duration of the entire treatment, patient satisfaction, type of temporary teeth and change in vertical dimension was collected from Dental Information Archiving Software (DIAS). The data censored was collected by recalling the patient and reviewing. Statistical analysis was performed using pearson's correlation and chi square test to assess the association between patient satisfaction and increase in the vertical dimension, type of temporisation and duration of the treatment. The associations between patient satisfaction and increase in vertical dimension (Chi-square value : 8.809, df: 6, p value : 0.185), type of temporisation (Chi-square value : 8.809, df: 6, p value : 0.185) and duration of the treatment (Chi-square value : 303.548, df: 306, p value : 0.529) were statistically insignificant (p&gt;0.05). From the available data it was observed the duration of the treatment plays a secondary role in relation to patient satisfaction in the treatment of full mouth rehabilitation cases. The quality of treatment and decisiveness in providing definitive care with respect to treatment needs gives better patient satisfaction.